Flu During Pregnancy Linked To Bipolar Disease in Offspring

Friday, August 02, 2013


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Flu contracted during pregnancy is linked to development of bipolar disorder in offspring, according to new research.

Keeping pregnant women safe from maternal influenza may reduce the risk of bipolar disorder (BD) in their offspring, according to a new study.

The new findings, from the Child Health and Development Study, showed that the offspring of women who had influenza during pregnancy had a nearly 4-fold increased risk of bipolar disorder developing in adulthood. This study adds to already existing links demonstrated between gestational influenza and schizophrenia in offspring.

“While there has previously been research looking at the association of in-utero exposure to infection/viral illness for schizophrenia, this is the first study I’ve seen looking specifically at the association between gestational influenza exposure and the development of bipolar disorder," said Neha S. Hudepohl, MD, a psychiatrist at the Center for Women’s Behavioral Health at Women & Infants Hospital. "An interesting point made in the original article is that there may be increased correlation between gestational influenza and maternal psychiatric illness – a point that may be significant when we consider the ‘classic’ risk factor for the development of bipolar disorder to be genetic/family history," Hudepohl said.

Flu + bipolar disease

The study involved nearly every pregnant woman who received obstetric care from Kaiser Permanente Medical Care Plan, Northern California Region (KPNC), which allowed for more detailed maternal influenza exposure information than in previous studies and for more standardized diagnostic and psychiatric measures.

Not only were offspring of women who had influenza at any time during their pregnancy nearly 4 times more likely to have a diagnosis of BD in adulthood than the offspring of women who did not have gestational influenza, but if maternal influenza occurred during the second or third trimesters, there was some evidence that the risk of BD was slightly greater than the overall risk.

Of particular interest was that gestational exposure to influenza was associated with 6-fold increase in risk of a subtype of BD with psychotic features. Maternal age, race, educational level, gestational age at birth, and maternal psychiatric disorders had no effect on these results.

Women & Infants experts weigh in

The study is "a great opportunity to remind people that we are lucky enough in this country to have flu vaccination, and that is a fantastic way to prevent major illness related to influenza for both moms and babies," said Brenna L. Anderson, MD, Director of Reproductive Infectious Disease Consultative Service and a Maternal-Fetal Medicine Specialist, Integrated Program for High-Risk Pregnancy Women & Infants Hospital. “The important thing to remember with this kind of study is that they are associations and have not been shown to be causal.  There may be other factors at work among people who also happen to get influenza.  That said,  If we can improve vaccination rates during pregnancy, that would be a major public health advancement.”

Study co-author Alan Brown, MD, PhD, of Columbia University and New York State Psychiatric Institute, concluded that women should be advised to avoid contact with symptomatic persons and to consider getting a flu shot. “In spite of public health recommendations, only a relatively small fraction of such women get immunized," Brown said. "The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.”  


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