Children born to starving mothers are more likely to develop schizophrenia, according to a new study of people conceived during the Chinese Famine of 1959 to 1961. The results support the idea that prenatal nutritional deficiency raises the risk of schizophrenia and provides hope that schizophrenia risk can be lowered by making sure pregnant women receive proper nutrition.
Schizophrenia has been linked to environmental insults that may harm fetal brain development, including viral infection and nutritional deficiency in the mother. The nutritional hypothesis got a boost in the early 1990s, when epidemiologists showed that people conceived in the Netherlands during the winter of 1944-1945, when Hitler's army blockaded food supplies to starve the Dutch, were twice as likely to develop schizophrenia in later life. But skeptics argued that a toxin in the tulip bulbs Dutch women ate to fend off starvation could have harmed brain development and pointed out that restoring nutrition to starving pregnant woman too quickly at the end of the famine could have harmed their unborn babies.
To test the nutritional hypothesis, geneticists David St. Clair of the University of Aberdeen, United Kingdom, and Lin He of Shanghai Jiao Tong University in Shanghai, China, analyzed three decades of records from the Fourth People's Hospital, the only psychiatric hospital in the Wuhu region of eastern China, which was hit hard by the 1959-1961 famine. After adjusting for differing rates of death, the researchers found that 2% of people conceived in during the famine years of 1960 or 1961 developed schizophrenia, as opposed to 0.9% of people conceived in the years before or after the famine. Because the starving Chinese women ate no tulip bulbs and only slowly regained an adequate food supply, the observed doubling of risk leads to the "very strong conclusion ... that during pregnancy the lack of nutrition definitely caused a high risk of schizophrenia," says He. The researchers report their findings 3 August in the Journal of the American Medical Association.
The study "offers a compelling confirmation" of the hypothesis that prenatal starvation raises schizophrenia risks, although the case is not ironclad, says epidemiologist Richard Neugebauer of the New York State Psychiatric Institute in New York City. If animal studies can identify exactly which nutrients are required to lower the risk of the disease, the results could lead to "an almost utopian opportunity" to reduce schizophrenia risk by ensuring pregnant women receive adequate nutrition, he says.