Association between maternal fever and psychological/behavior outcomes: A hypothesis

Dombrowski, Stefan C.; Martin, Roy P.; Huttunen, Matti

doi:10.1002/bdra.10096

Cited by 43 publications

(38 citation statements)

References 32 publications

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“…In 3 studies on childhood autism 16,56 and autism spectrum disorders, 38 an increased risk was observed in relation to fever exposure. Increased risks were also reported for cerebral palsy, 15,49 developmental delay, 38 various behavior characteristics, 19 decreased academic performance, 19 and psychosis. 57 No overall association was reported for epilepsy 17 or schizophrenia, 21 however.…”

Section: Fever and Health Effects In The Childmentioning

confidence: 97%

“…Whether exposure later in pregnancy is harmful was less studied. Both the studies by Dombrowski et al 19 and by Calvani et al, 53 however, suggest that exposures in middle and late pregnancy may lead to longer-term adverse effects in the child. Nevertheless, the current evidence is insufficient to conclude whether fever might be harmful in all stages of pregnancy.…”

Section: Figurementioning

confidence: 99%

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Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

2014

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BACKGROUND AND OBJECTIVE: Fever during pregnancy has been suspected to harm the developing fetus. However, until now, no systematic analysis of the available evidence has been undertaken to assess the impact of maternal fever on health outcomes in the child. The goal of this study was to systematically review evidence from epidemiologic studies on adverse health outcomes of the offspring in relation to exposure to maternal fever during pregnancy. METHODS: Systematic searches in PubMed, Web of Science, and the Cochrane Library were performed by using Medical Subject Headings, Boolean operators, and truncation, and references of references were reviewed. Cohort and case-control studies addressing health outcomes of prenatal fever exposure in humans were eligible for inclusion. Studies with no direct reference to fever, studies in selected populations (eg, preterm births), and studies published before 1990 were excluded. RESULTS: The available literature supported an increased risk of adverse offspring health in association with fever during pregnancy. The strongest evidence was available for neural tube defects, congenital heart defects, and oral clefts, in which meta-analyses suggested between a 1.5- and nearly 3-fold increased risk with fever exposure in the first trimester. We did not find strong evidence of a dose–response relationship, but there was some evidence that antipyretic medications may have a protective effect when used in relation to febrile episodes. CONCLUSIONS: We found substantial evidence to support the contention that maternal fever during pregnancy may negatively affect offspring health. The harmful effects seemed to cover both short- and longer-term health outcomes; however, for several outcomes, the evidence was insufficient to judge any association.

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Section: Fever and Health Effects In The Childmentioning

confidence: 97%

Section: Figurementioning

confidence: 99%

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

2014

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“…Epidemiological evidence, for instance, indicates higher incidences of psychopathologies, including schizophrenia, negative emotionality and panic disorders in children exposed to viral or bacterial infections in-utero [1], [2] or in early life [3]. Animal models that have been utilised to examine the impact of immune activation in early life have repeatedly demonstrated that exposure to bacterial or viral agents including mimetics (e.g.…”

Section: Introductionmentioning

confidence: 99%

Functional Programming of the Autonomic Nervous System by Early Life Immune Exposure: Implications for Anxiety

et al. 2013

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Neonatal exposure of rodents to an immune challenge alters a variety of behavioural and physiological parameters in adulthood. In particular, neonatal lipopolysaccharide (LPS; 0.05 mg/kg, i.p.) exposure produces robust increases in anxiety-like behaviour, accompanied by persistent changes in hypothalamic-pituitary-adrenal (HPA) axis functioning. Altered autonomic nervous system (ANS) activity is an important physiological contributor to the generation of anxiety. Here we examined the long term effects of neonatal LPS exposure on ANS function and the associated changes in neuroendocrine and behavioural indices. ANS function in Wistar rats, neonatally treated with LPS, was assessed via analysis of tyrosine hydroxylase (TH) in the adrenal glands on postnatal days (PNDs) 50 and 85, and via plethysmographic assessment of adult respiratory rate in response to mild stress (acoustic and light stimuli). Expression of genes implicated in regulation of autonomic and endocrine activity in the relevant brain areas was also examined. Neonatal LPS exposure produced an increase in TH phosphorylation and activity at both PNDs 50 and 85. In adulthood, LPS-treated rats responded with increased respiratory rates to the lower intensities of stimuli, indicative of increased autonomic arousal. These changes were associated with increases in anxiety-like behaviours and HPA axis activity, alongside altered expression of the GABA-A receptor α2 subunit, CRH receptor type 1, CRH binding protein, and glucocorticoid receptor mRNA levels in the prefrontal cortex, hippocampus and hypothalamus. The current findings suggest that in addition to the commonly reported alterations in HPA axis functioning, neonatal LPS challenge is associated with a persistent change in ANS activity, associated with, and potentially contributing to, the anxiety-like phenotype. The findings of this study reflect the importance of changes in the perinatal microbial environment on the ontogeny of physiological processes.

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“…Other prominent defects are seen in craniofacial development, such as facial clefts [103], the skeleton [104], the body wall, teeth, and heart [105]. Hyperthermia in utero [due to maternal influenza for instance] was long known to potentially induce structural anomalies in the fetus [106][107][108] but it has been described also as an environmental risk factor for psychological/behavioral disturbances [109] and, more particularly, schizophrenia [107]. It is stressed that these are not ultrasound-induced hyperthermia effects.…”

Section: Fetal Susceptibility To External Insultsmentioning

confidence: 99%

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Abramowicz

2016

First-Trimester Ultrasound

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1"Ultrasound is safe. Ultrasound is not X-rays. Our machines are FDA-approved." These are the statements most commonly made when initiating a conversation on safety of ultrasound. This is one of the reasons cited for its becoming an essential tool in medicine (together with its relatively low cost and immediate results availability). Diagnostic ultrasound (DUS) has been in use for over half a century in obstetrics and gynecology [1] and the benefits of this technology are multiple [2]. Most pregnant women have 2-3 ultrasound examinations (and many more in certain countries) during their pregnancies. In early pregnancy and before (i.e., in Artificial Reproductive Technologies [(ART]), these include serial scans of the developing follicles during ovulation induction [3] and in the earliest stages of gestation [4], first-trimester ultrasound for viability and/or aneuploidy screening (nuchal translucency, NT) and, more and more, early anatomy survey [5]. Such is the widespread enthusiasm and the generally accepted notion of safety that its use has spilled into the commercial world with mall stores offering non-medical ultrasound or "souvenir" scans. The record of safety of DUS is excellent: there are no epidemiological studies demonstrating harmful effects in human fetuses [6]. Most human epidemiological studies, however, published so far are based on information obtained with pre-1991/1992 machines. Around that time, the US Federal Drug Administration (FDA) allowed the acoustic output of ultrasound machines for fetal use to be increased from 94 to 720 mW/cm 2 , a factor of almost 8 [7,8]. Is there enough evidence to validate the use of ultrasound imaging in general and Doppler in particular in the first trimester [9] and could ultrasound have detrimental effects on the fetus in the first trimester, a time of maximal susceptibility to external factors? If there are clinical indications to perform these scans (and if there were none, there would be no raison-d'être for this book) safety must be guaranteed by educating the end-users on ways to limit the possible hazards of exposure of the follicles/ova and the fetus at early stages of gestation [2].

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Association between maternal fever and psychological/behavior outcomes: A hypothesis

Cited by 43 publications

References 32 publications

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring

Functional Programming of the Autonomic Nervous System by Early Life Immune Exposure: Implications for Anxiety

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

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