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

1. 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.

Fond G(1)(2)(3)(4), Bulzacka E(5)(6)(7), Boyer L(8), Llorca PM(5)(9), Godin
O(5)(10), Brunel L(5)(6)(7), Andrianarisoa MG(5)(6)(7), Aouizerate B(5)(11)(12),
Berna F(5)(13), Capdevielle D(5)(14), Chereau I(5)(9), Denizot H(5)(9), Dorey
JM(5)(15), Dubertret C(5)(16), Dubreucq J(5)(17), Faget C(5)(18), Gabayet
F(5)(17), Le Strat Y(5)(16), Micoulaud-Franchi JA(19), Misdrahi D(5)(11)(20),
Rey R(5)(15), Richieri R(5)(18), Roger M(5)(6)(7), Passerieux C(5)(21),
Schandrin A(5)(14), Urbach M(5)(21), Vidalhet P(13), Schürhoff F(5)(6)(7),
Leboyer M(5)(6)(7); FondaMental Academic Centers of Expertise for Schizophrenia
(FACE-SZ) Group.

Collaborators: Aouizerate B, Berna F, Blanc O, Brunel L, Bulzacka E, Capdevielle
D, Chereau-Boudet I, Chesnoy-Servanin G, Danion JM, D’Amato T, Deloge A, Delorme
C, Denizot H, De Pradier M, Dorey JM, Dubertret C, Dubreucq J, Faget C, Fluttaz
C, Fond G, Fonteneau S, Gabayet F, Giraud-Baro E, Hardy-Bayle MC, Lacelle D,
Lançon C, Laouamri H, Leboyer M, Le Gloahec T, Le Strat Y, Llorca PM, Metairie
E, Misdrahi D, Offerlin-Meyer I, Passerieux C, Peri P, Pires S, Portalier C, Rey
R, Roman C, Sebilleau M, Schandrin A, Schurhoff F, Tessier A, Tronche AM, Urbach
M, Vaillant F, Vehier A, Vidailhet P, Vilà E, Yazbek H, Zinetti-Bertschy A.

Author information:
(1)Fondation FondaMental, Créteil, France. .
(2)Translational Psychiatry Laboratory, INSERM U955, Créteil, France.
.
(3)DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Paris
Est University, Créteil, France. .
(4)Hôpital A. Chenevier, Pole de Psychiatrie, 40 rue de Mesly, 94010, Créteil,
France. .
(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.

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.

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

Auteurs Bordeaux Neurocampus