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

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.

The Impact of Cesarean and Vaginal Delivery on Results of Psychological Cognitive Test in 5 Year Old Children

“…Experimental studies described the changes in dopamine concentrations and changes in dopamine-mediated behaviors [ 24 ], as well as noradrenaline concentrations [ 25 ]. It is postulated that this difference in microbiota may affect the development of brain and the later increase in the risk of diseases such as schizophrenia [ 26 ]. The differences in the type of delivery and children’s cognitive development related to the effect of the gut microbiota may be explained by chemical signaling from the gut microbiota to the central nervous system, affecting memory, motivation, mood, and reactivity to stress [ 27 ].…”

The Gut Microbiome and Schizophrenia: The Current State of the Field and Clinical Applications

“…not actually indicative of a schizophrenia-like phenotype. Finally, there is very little data on possible sources of dysbiosis, with Csection-a commonly suggested cause of dysbiosis (30)-found not to be associated with schizophrenia (31,32).…”

Cesarean Section or Natural Childbirth? Cesarean Birth May Damage Your Health

“…Schizophrenia is a serious and disruptive mental disorder that has a substantial effect on public health (Collins et al, 2011). Schizophrenia and Cesarean birth are associated (Verdoux et al, 1997; Boksa and Ei-Khodor, 2003; Fond et al, 2016). For instance, Verdoux et al (1997) found that the incidence of early onset schizophrenia in a group of Cesarean births was 10 times higher than the incidence of late onset schizophrenia, which suggests that Cesarean birth is associated with the early onset of schizophrenia.…”