University of Oulu

Hugh Ramsay, Heljä-Marja Surcel, Lassi Björnholm, Martta Kerkelä, Golam M Khandaker, Juha Veijola, Associations Between Maternal Prenatal C-Reactive Protein and Risk Factors for Psychosis in Adolescent Offspring: Findings From the Northern Finland Birth Cohort 1986, Schizophrenia Bulletin, Volume 47, Issue 3, May 2021, Pages 766–775,

Associations between maternal prenatal C-reactive protein and risk factors for psychosis in adolescent offspring : findings from the Northern Finland Birth Cohort 1986

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Author: Ramsay, Hugh1,2; Surcel, Heljä-Marja3,4; Björnholm, Lassi1;
Organizations: 1Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
2Department of Psychiatry, Trinity College, Dublin, Ireland
3Faculty of Medicine, University of Oulu, Oulu, Finland
4Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland
5Department of Psychiatry, University of Cambridge, Cambridge, UK
6Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
7Department of Psychiatry, Oulu University Hospital, Oulu, Finland
8Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Oxford University Press, 2021
Publish Date: 2021-06-07


Prenatal infection is associated with brain structural and functional abnormalities and may increase the risk for psychosis through a direct effect on neurodevelopment. Various infections may exert their effect through a proinflammatory immune response but studies of prenatal maternal inflammatory markers and offspring neurodevelopment are scarce. Using the longitudinal Northern Finland Birth Cohort 1986 study, we examined the associations of maternal prenatal C-reactive protein (CRP) levels with psychosis risk factors in adolescent offspring. CRP was measured in maternal sera collected in pregnancy. In offspring, school performance was measured at age 7 years, while school performance, psychotic experiences, and cannabis use were measured at age 16 years. We tested associations of CRP with offspring measures using regression analysis controlling for offspring sex, maternal education level, and prenatal maternal body mass index, smoking and alcohol use in pregnancy, place of birth, maternal psychiatric admission, paternal psychiatric admission, mothers age at birth, and gestational week of CRP sample. We also tested if adolescent cannabis use mediated the associations between maternal CRP and offspring outcomes. Controlling for covariates, maternal CRP was associated with academic performance at age 16 years (beta = .062, 95% CI = 0.036–0.088), but not with possible psychotic experiences at 16 years (odds ratio [OR] = 1.09, 95% CI = 0.96–1.24). Maternal CRP was also associated with adolescent cannabis use (OR = 1.24, 95% CI = 1.07–1.43). These findings suggest that prenatal inflammation may influence later mental illness risk by affecting neurodevelopment and also indirectly by increasing the risk of exposure to cannabis.

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Series: Schizophrenia bulletin
ISSN: 0586-7614
ISSN-E: 1745-1707
ISSN-L: 0586-7614
Volume: 47
Issue: 3
Pages: 766 - 775
DOI: 10.1093/schbul/sbaa152
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: The Northern Finland Birth Cohort (NFBC) has been funded by the European Commission (EURO-BLCS, Framework 5 award QLGI-CT-2000-01643, grant no. E51560, the Nordic Research Training Academy (NorFA) (grant nos. 731, 20056, 30167), United States National Institutes of Health (UHS/NIH) 2000G DF682 (grant no. 50945), and the researchers’ own funding. G.M.K. acknowledges funding support from the Wellcome Trust (Intermediate Clinical Fellowship 201486/Z/16/Z), the MQ: Transforming Mental Health (Data Science Award MQDS17/40), the Medical Research Council (Mental Health Pathfinder MC_PC_17213, and Therapeutic Target Validation in Mental Health MR/S037675/1), and the British Medical Association Foundation (J Moulton grant 2019).
Copyright information: © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.