Citation

Guo C, He P, Song X, Zheng X. Br. J. Psychiatry 2019; ePub(ePub): 1-6.

Affiliation

Professor and Director,Institute of Population Research, Peking University; andDean,APEC Health Science Academy,Peking University,China.

Copyright

(Copyright © 2019, Royal College of Psychiatry)

DOI

10.1192/bjp.2019.114

PMID

31113505

Abstract

BACKGROUND: Maternal exposure to major stressors during pregnancy has been found to increase the risk of neurodevelopmental, cognitive and psychiatric disorders in the offspring. However, the association between prenatal exposure to earthquake and the risk of adult schizophrenia has yet to be examined.AimsTo explore the potential long-term effects of prenatal exposure to maternal stress on the risk of schizophrenia in adulthood, using the Great Tangshan Earthquake in 1976 as a natural experiment.

METHOD: We obtained data from the Second China National Sample Survey on Disability, and analysed 94 410 Chinese individuals born between 1975 and 1979. We obtained difference-in-differences estimates of the earthquake effects on schizophrenia by exploiting temporal variation in the timing of earthquake exposure across four birth cohorts born between 1975 and 1979, along with geographical variation in earthquake severity at the prefecture level. Schizophrenia was ascertained by psychiatrists using the ICD-10 classification. Earthquake severity was measured by seismic intensity.

RESULTS: Earthquake cohort who experienced prenatal exposure to felt earthquake had higher risk of schizophrenia (odds ratio, 3.38; 95% CI 1.43-8.00) compared with the unexposed reference cohort. After specifying the timing of exposure by the trimester of pregnancy, prenatal exposure to felt earthquake during the first trimester of pregnancy increased the risk of adulthood schizophrenia significantly (odds ratio, 7.45; 95% CI 2.83-19.59).

CONCLUSIONS: Prenatal (particularly early pregnancy) exposure to maternal stress after a major disaster substantially affects the mental health of Chinese adults.

Declaration of interest: None.

Language: en

Keywords

Maternal stress; earthquake; natural experiment; schizophrenia