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    Maternal smoking and schizophrenia

    A first-of-its-kind study of a biomarker for nicotine exposure suggests that there may be a link between maternal smoking and schizophrenia in offspring. The results, published in The American Journal of Psychiatry, are from a population-based analysis by Finnish researchers.

    For the nested case-control study, the authors examined the relationship between prenatal nicotine exposure (or cotinine level) in archived maternal sera and schizophrenia in the women’s offspring. All live births in Finland between 1983 and 1998 were represented. The 997 cases of schizophrenia identified in a national registry were matched 1:1 to controls based on date of birth, sex, and residence. Data on serum levels of cotinine were from a national biobank and the samples were drawn from early- to mid-gestation and measured prospectively using quantitative immunoassay.

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    Increased odds of schizophrenia were associated with a higher maternal cotinine level (odds ratio=3.41, 95% confidence interval, 1.86-6.24). Categorically defined heavy maternal nicotine exposure was associated with a 38% increase in the risk of schizophrenia. The findings were not altered by adjustment for maternal age, maternal or paternal psychiatric disorders, socioeconomic status, or other covariates. Weight for gestational age also did not appear to affect the association.

    The study, the authors said, is the first to look at the relationship between a biomarker for maternal smoking and schizophrenia. Their findings, they believe, suggest that preventing smoking during pregnancy may decrease the incidence of schizophrenia and they are the most definitive evidence to date of the association.

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    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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