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Long-term effects of prenatal exposure to earthquake on adult schizophrenia

  • Chao Guo (a1), Ping He (a2), Xinming Song (a3) and Xiaoying Zheng (a4)

Abstract

Background

Maternal exposure to major stressors during pregnancy has been found to increase the risk of neurodevelopmental, cognitive and psychiatric disorders in the offspring. However, the association between prenatal exposure to earthquake and the risk of adult schizophrenia has yet to be examined.

Aims

To explore the potential long-term effects of prenatal exposure to maternal stress on the risk of schizophrenia in adulthood, using the Great Tangshan Earthquake in 1976 as a natural experiment.

Method

We obtained data from the Second China National Sample Survey on Disability, and analysed 94 410 Chinese individuals born between 1975 and 1979. We obtained difference-in-differences estimates of the earthquake effects on schizophrenia by exploiting temporal variation in the timing of earthquake exposure across four birth cohorts born between 1975 and 1979, along with geographical variation in earthquake severity at the prefecture level. Schizophrenia was ascertained by psychiatrists using the ICD-10 classification. Earthquake severity was measured by seismic intensity.

Results

Earthquake cohort who experienced prenatal exposure to felt earthquake had higher risk of schizophrenia (odds ratio, 3.38; 95% CI 1.43–8.00) compared with the unexposed reference cohort. After specifying the timing of exposure by the trimester of pregnancy, prenatal exposure to felt earthquake during the first trimester of pregnancy increased the risk of adulthood schizophrenia significantly (odds ratio, 7.45; 95% CI 2.83–19.59).

Conclusions

Prenatal (particularly early pregnancy) exposure to maternal stress after a major disaster substantially affects the mental health of Chinese adults.

Declaration of interest

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.

Corresponding author

Correspondence: Xiaoying Zheng, Institute of Population Research/APEC Health Science Academy (HeSAY), Peking University, no. 5 Yi He Yuan Lu, Beijing 100871, China. Email: xzheng@pku.edu.cn

References

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1Li, N, Chen, G, Du, W, Song, X, Zhang, L, Zheng, X. Population-level prevalence estimate and characteristics of psychiatric disability among Chinese adults. J Psychiatr Res 2011; 45(11): 1530–4.
2Clair, DS, Xu, M, Wang, P, Yu, Y, Fang, Y, Zhang, F, et al. Rates of adult schizophrenia following prenatal exposure to the Chinese famine of 1959–1961. JAMA 2005; 294: 557–62.
3Babenko, O, Kovalchuk, I, Metz, GA. Stress-induced perinatal and transgenerational epigenetic programming of brain development and mental health. Neurosci Biobehav Rev 2015; 48(1): 7091.
4World Health Organization (WHO). International Classification of Functioning, Disability, and Health (ICF). WHO, 2001.
5Zhang, J. Study of Disability Survey Method. Peking University, 2010 (in Chinese).
6World Health Organization (WHO). The World Health Organization Disability Assessment Schedule Phase II Field Trial Instrument. WHO, 1999.
7Ulug, B, Ertugrul, A, Gögüs, A, Kabakcı, E. Reliability and validity of the Turkish version of the World Health Organization disability assessment schedule (WHO–DAS-II). Turk J Psychiatry 2001; 12: 121–30.
8World Health Organization (WHO). The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. WHO, 1993.
9Xiang, Y, Ma, X, Cai, Z, Li, S, Xiang, Y, Guo, H, et al. Prevalence and socio-demographic correlates of schizophrenia in Beijing, China. Schizophr Res 2008; 102(1–3): 270–7.
10Hsieh, Y. A new scale of seismic intensity adapted to the conditions in Chinese territories. Chinese J Geophys 1957; 6(1): 3547.
11Gutierrez, E, Taucer, F, De Groeve, T, Al-Khudhairy, DH, Zaldivar, JM. Analysis of worldwide earthquake mortality using multivariate demographic and seismic data. Am J Epidemiol 2005; 161(12): 1151–8.
12Glover, V. Annual research review: prenatal stress and the origins of psychopathology: an evolutionary perspective. J Child Psychol Psychiatry 2011; 52(4): 356–67.
13Ben-Shlomo, Y, Kuh, D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol 2002; 31(2): 285–93.
14Wang, X, Shi, S, Zhang, B, Ma, W, Jiang, T, Sun, H. Adult schizotypal personality characteristics of a fetus exposed to Tangshan earthquake in its sixth month of gestation. J Clin Rehab Tissue Engineering Res 2007; 11(39): 7838–41 (in Chinese).
15Cai, D, Zhu, Z, Sun, H, Qi Y, Xing L, Zhao X, et al. Maternal PTSD following exposure to the Wenchuan earthquake is associated with impaired mental development of children. PLoS ONE 2017; 12(4): e0168747.
16King, S, Dancause, K, Turcotte-Tremblay, AM, Veru, F, Laplante, DP. Using natural disasters to study the effects of prenatal maternal stress on child health and development. Birth Defects Res C Embryo Today 2012; 96(4): 273–88.
17Selten, JP, van der Graaf, Y, van Duursen, R, Gispen-de Wied, CC, Kahn, RS. Psychotic illness after prenatal exposure to the 1953 Dutch flood disaster. Schizophr Res 1999; 35(3): 243–5.
18Weinstein, Y, Levav, I, Gelkopf, M, Roe, D, Yoffe, R, Pugachova, I, et al. Association of maternal exposure to terror attacks during pregnancy and the risk of schizophrenia in the offspring: a population-based study. Schizophr Res 2018; 199: 163–7.
19Khashan, AS, Abel, KM, McNamee, R, Pedersen, MG, Webb, RT, Baker, PN, et al. Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events. Arch Gen Psychiatry 2008; 65(2): 146–52.
20Palmer, SR, Evans, A, Broughton, H, Huddart, S, Drayton, M, Rankin, J, et al. The role of maternal stress in early pregnancy in the aetiology of gastroschisis: an incident case control study. PLoS ONE 2013; 8(11): e80103.
21Wadhwa, PD, Culhane, JF, Rauh, V, Barve, SS. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J 2001; 5(2): 119–25.
22Udagawa, J, Hino, K. Impact of maternal stress in pregnancy on brain function of the offspring. Nihon Eiseigaku Zasshi 2016; 71(3): 188–94.
23Seltzer, CC, Jablon, S. Effects of selection on mortality. Am J Epidemiol 1974; 100(5): 367–72.
24Mu, R, Zhang, X. Why does the Great Chinese Famine affect the male and female survivors differently? Mortality selection versus son preference. Econ Hum Biol 2011; 9(1): 92105.
25McGrath, J, Saha, S, Chant, D, Welham, J. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev 2008; 30: 6776.

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Long-term effects of prenatal exposure to earthquake on adult schizophrenia

  • Chao Guo (a1), Ping He (a2), Xinming Song (a3) and Xiaoying Zheng (a4)
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