VIRUSES,
FETAL HYPOXIA AND SUBSEQUENT SCHIZOPHRENIA: A DIRECT TEST OF
INFECTIOUS AGENTS USING PRENATAL SERA
S.L. Buka*,
R.H. Yolken, E.F. Torrey, M.A. Klebanoff, M.T. Tsuang. Department
of Psychiatry, Harvard Medical School, Boston, MA
There remains much debate
regarding the role in utero exposure to viruses and other
infectious agents in the etiology of schizophrenia. There are no
studies to date that provide a definite link between an
infectious agent and psychosis. Our follow-up work with the
Providence and Boston cohorts of the National Collaborative
Perinatal Project provides an unprecedented opportunity to
examine these topics. This study included over 16,000 pregnancies
enrolled during the 1960s and followed prospectively from
the first prenatal visit through the age of seven. Maternal blood
samples were drawn during each trimester of pregnancy under
study, along with infant cord samples; these sera have been
well-maintained at NIH facilities. We have conducted a pilot
case-control study involving subjects from the Providence cohort.
We identified 35 subjects diagnosed with psychotic disorder and
70 control subjects with no history of major psychiatric
disorders, matched for age, race and gender. Three classes of
assays have been conducted, most using quantitative solid phase
enzyme immunoassays employing as little as 1 ul of serum. These
have included: 1) antibodies to specific infectious agents (e.g.,
influenza, Herpes simplex, toxoplasmosis); 2) indicators of
immune activation (cytokines); and 3) indicators of fetal
distress and anoxia (erthropoetin). Preliminary analyses indicate
a possible association of infectious, inflammatory, and hypoxic
events during pregnancy and the development of psychosis in adult
life.