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

G. Fond, , E. Bulzacka, L. Boyer, P. M. Llorca, O. Godin, L. Brunel, M. G. Andrianarisoa, B. Aouizerate, F. Berna, D. Capdevielle, I. Chereau, H. Denizot, J. M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, Y. Le Strat, J. A. Micoulaud-Franchi, D. Misdrahi, R. Rey, R. Richieri, M. Roger, C. Passerieux, A. Schandrin, M. Urbach, P. Vidalhet, F. Schürhoff, M. Leboyer
Eur Arch Psychiatry Clin Neurosci. 2016-06-27; 267(6): 587-594
DOI: 10.1007/s00406-016-0708-3

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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

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