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Eur Arch Psychiatry Clin Neurosci. 2017 Sep;267(6):587-594. doi: 10.1007/s00406-016-0708-3. Epub 2016 Jun 27.

Birth by cesarean section and schizophrenia: results from the multicenter FACE-SZ data-set.

Author information

1
Fondation FondaMental, Créteil, France. guillaume.fond@gmail.com.
2
Translational Psychiatry Laboratory, INSERM U955, Créteil, France. guillaume.fond@gmail.com.
3
DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Paris Est University, Créteil, France. guillaume.fond@gmail.com.
4
Hôpital A. Chenevier, Pole de Psychiatrie, 40 rue de Mesly, 94010, Créteil, France. guillaume.fond@gmail.com.
5
Fondation FondaMental, Créteil, France.
6
Translational Psychiatry Laboratory, INSERM U955, Créteil, France.
7
DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Paris Est University, Créteil, France.
8
CHU Sainte-Marguerite, Pôle Psychiatrie Universitaire, 13274, Marseille Cedex 09, France.
9
CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003, Clermont-Ferrand Cedex 1, France.
10
UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, 75013, UPMC Univ Paris 06, Sorbonne Universités, 75013, Paris, France.
11
Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.
12
Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Inserm, U862, 33000, Bordeaux, France.
13
INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
14
Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, Inserm 1061, CHRU Montpellier, Université Montpellier 1, Montpellier, France.
15
Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, BP 300 39, 95 bd Pinel, 69678, Bron Cedex, France.
16
AP-HP, Department of Psychiatry, Faculté de Médecine, Louis Mourier Hospital, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Colombes, France.
17
Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France.
18
Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France.
19
Bordeaux Sleep Clinique, Pellegrin University Hospital, USR CNRS 3413 SANPSY, Research Unit, Bordeaux University, 33000, Bordeaux, France.
20
CNRS UMR 5287-INCIA, Talence, France.
21
Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France.

Abstract

Children born by cesarean section ("c-birth") are known to have different microbiota and a natural history of different disorders including allergy, asthma and overweight compared to vaginally born ("v-birth") children. C-birth is not known to increase the risk of schizophrenia (SZ), but to be associated with an earlier age at onset. To further explore possible links between c-birth and SZ, we compared clinical and biological characteristics of c-born SZ patients compared to v-born ones. Four hundred and fifty-four stable community-dwelling SZ patients (mean age = 32.4 years, 75.8 % male gender) were systematically included in the multicentre network of FondaMental Expert Center for schizophrenia. Overall, 49 patients (10.8 %) were c-born. These subjects had a mean age at schizophrenia onset of 21.9 ± 6.7 years, a mean duration of illness of 10.5 ± 8.7 years and a mean PANSS total score of 70.9 ± 18.7. None of these variables was significantly associated with c-birth. Multivariate analysis showed that c-birth remained associated with lower CRP levels (aOR = 0.07; 95 % CI 0.009-0.555, p = 0.012) and lower premorbid ability (aOR = 0.945; 95 % CI 0.898-0.994, p = 0.03). No significant association between birth by C-section and, respectively, age, age at illness onset, sex, education level, psychotic and mood symptomatology, antipsychotic treatment, tobacco consumption, birth weight and mothers suffering from schizophrenia or bipolar disorder has been found. Altogether, the present results suggest that c-birth is associated with lower premorbid intellectual functioning and lower blood CRP levels in schizophrenia. Further studies should determine the mechanisms underlying this association.

KEYWORDS:

C-reactive protein (CRP); Cesarean section birth (C-section); Microbiota; Schizophrenia; Weight

PMID:
27349652
DOI:
10.1007/s00406-016-0708-3
[Indexed for MEDLINE]

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