OBJECTIVE Previous studies suggest that prenatal immune challenges may elevate the risk of schizophrenia and related psychoses in offspring, yet there has been limited research focused on maternal bacterial infection. The authors hypothesized that maternal bacterial infection during pregnancy increases offspring risk of psychotic disorders in adulthood, and that the magnitude of this association varies as a function of severity of infectious exposure and offspring sex. METHODS The authors analyzed prospectively collected data from 15,421 pregnancies among women enrolled between 1959 and 1966 at two study sites through the Collaborative Perinatal Project. The sample included 116 offspring with confirmed psychotic disorders. The authors estimated associations between maternal bacterial infection during pregnancy and psychosis risk over the subsequent 40 years, stratified by offspring sex and presence of reported parental mental illness, with adjustment for covariates. RESULTS Maternal bacterial infection during pregnancy was strongly associated with psychosis in offspring (adjusted odds ratio=1.8, 95% CI=1.2-2.7) and varied by severity of infection and offspring sex. The effect of multisystemic bacterial infection (adjusted odds ratio=2.9, 95% CI=1.3-5.9) was nearly twice that of less severe localized bacterial infection (adjusted odds ratio=1.6, 95% CI=1.1-2.3). Males were significantly more likely than females to develop psychosis after maternal exposure to any bacterial infection during pregnancy. CONCLUSIONS The study findings suggest that maternal bacterial infection during pregnancy is associated with an elevated risk for psychotic disorders in offspring and that the association varies by infection severity and offspring sex. These findings call for additional investigation and, if the findings are replicated, public health and clinical efforts that focus on preventing and managing bacterial infection in pregnant women.

中文翻译：

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孕期和后代患精神病的风险中的母体细菌感染：感染程度和后代性别的差异。

目的先前的研究表明，产前免疫挑战可能会增加后代精神分裂症和相关精神病的风险，但针对母体细菌感染的研究很少。作者假设怀孕期间的母亲细菌感染会增加成年后患精神病的后代风险，并且这种关联的程度会随着感染暴露的严重程度和后代性别的变化而变化。方法作者分析了从1959年至1966年在两个研究地点通过合作围产期项目入组的15421名孕妇的前瞻性收集数据。样本包括116名确诊为精神病的后代。作者估计了孕期孕产妇细菌感染与随后40年的精神病风险之间的关联，并按后代性别和所报告的父母精神疾病的存在进行了分层，并对协变量进行了调整。结果孕期孕产妇细菌感染与后代精神病密切相关（校正比值比= 1.8、95％CI = 1.2-2.7），并随感染的严重程度和后代性别而异。多系统细菌感染的影响（调整后的优势比= 2.9，95％CI = 1.3-5.9）几乎是较不严重的局部细菌感染（调整后的优势比= 1.6，95％CI = 1.1-2.3）的两倍。在孕期母亲暴露于任何细菌感染后，男性比女性明显容易患上精神病。结论研究结果表明，怀孕期间的母亲细菌感染与后代精神病的风险升高有关，并且这种关联因感染的严重程度和后代性别而异。这些发现需要进行进一步的调查，如果发现有重复，则需要进行公共卫生和临床工作，重点放在预防和控制孕妇的细菌感染上。