Friday, 27 May 2016

Prenatal Smoking and Offspring Schizophrenia

The topic prevention of brain disorders  is commonly neglected. This is despite increasing evidence for evidence-based support for prevention opportunities.

This issue is highlighted in a recent study out of Finland that examined prenatal nicotine metabolite levels and offspring diagnosis of schizophrenia.

In this study, Solja Niemela and the Finnish research team examined all live births in Finland between 1983 and 1998.

What makes this study powerful is the measurement of maternal serum cotinine levels in maternal serum during the early and mid stages of prenancy. Cotinine is a metabolite and the levels of cotinine reflect the level of nicotine consumption.

The key findings from this study include the following points:

  • Measuring cotinine levels as a continuous variable yielded an increased odds ratio for schizophrenia of 3.41 (95% CI 1.86-6.24)
  • Mothers in the highest cotinine level group had a 38% increase in offspring schizophrenia rates
  • These findings included controlling for potential confounding variables including maternal age and parental history of psychiatric disorders

Interestingly a PubMed search found a second study linking maternal smoking with increased risk of offspring diagnosis of bipolar disorder (odds ratio 2.01, 95% CI 1.48-2.53).

These two studies in combination support a potential non-specific effect of prenatal nicotine exposure on risk for two of the most impairing psychiatric disorders

These two studies also support aggressive smoking cessation efforts in young women before pregnancy or at the latest very early after conception.

You can find more information about these two studies by clicking on the citation links below.

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Niemelä, S., Sourander, A., Surcel, H., Hinkka-Yli-Salomäki, S., McKeague, I., Cheslack-Postava, K., & Brown, A. (2016). Prenatal Nicotine Exposure and Risk of Schizophrenia Among Offspring in a National Birth Cohort American Journal of Psychiatry DOI: 10.1176/appi.ajp.2016.15060800

Talati A, Bao Y, Kaufman J, Shen L, Schaefer CA, & Brown AS (2013). Maternal smoking during pregnancy and bipolar disorder in offspring. The American journal of psychiatry, 170 (10), 1178-85 PMID: 24084820

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