Original Article

Molecular Psychiatry (2014) 19, 259–264; doi:10.1038/mp.2012.197; published online on 22 January 2013

Elevated maternal C-reactive protein and autism in a national birth cohort

A S Brown1,2, A Sourander1,3,4, S Hinkka-Yli-Salomäki3,4, I W McKeague5, J Sundvall6 and H-M Surcel7

  1. 1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
  2. 2Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
  3. 3Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
  4. 4Department of Child Psychiatry, Turku University Hospital, Turku, Finland
  5. 5Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
  6. 6Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
  7. 7National Institute for Health and Welfare, Oulu, Finland

Correspondence: Dr AS Brown, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 23, New York, NY 10032, USA. E-mail: asb11@columbia.edu

Received 22 May 2012; Revised 15 November 2012; Accepted 3 December 2012
Advance online publication 22 January 2013

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Abstract

Autism is a complex neuropsychiatric syndrome with a largely unknown etiology. Inflammation during pregnancy may represent a common pathway by which infections and other insults increase risk for the disorder. Hence, we investigated the association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and childhood autism in a large national birth cohort with an extensive serum biobank. Other strengths of the cohort included nearly complete ascertainment of pregnancies in Finland (N=1.2 million) over the study period and national psychiatric registries consisting of virtually all treated autism cases in the population. Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with autism in offspring. For maternal CRP levels in the highest quintile, compared with the lowest quintile, there was a significant, 43% elevated risk. This finding suggests that maternal inflammation may have a significant role in autism, with possible implications for identifying preventive strategies and pathogenic mechanisms in autism and other neurodevelopmental disorders.

Keywords:

Autism; prenatal; C-reactive protein; infection; inflammation; cytokines