Maternal cortisol during pregnancy and offspring schizophrenia: Influence of fetal sex and timing of exposure

Schizophr Res. 2019 Nov:213:15-22. doi: 10.1016/j.schres.2019.07.002. Epub 2019 Jul 22.


Introduction: Maternal stress during pregnancy has been repeatedly linked to increased risk for schizophrenia; however, no study has examined maternal cortisol during pregnancy and risk for the disorder. Study aims were to determine whether prenatal cortisol was associated with risk for schizophrenia and risk for an intermediate phenotype-decreased fetal growth-previously linked to prenatal cortisol and schizophrenia. Timing of exposure and fetal sex also were examined given previous findings.

Methods: Participants were 64 cases diagnosed with schizophrenia spectrum disorders (SSD) and 117 controls from a prospective birth cohort study. Maternal cortisol was determined from stored sera from each trimester and psychiatric diagnoses were assessed from offspring using semi-structured interviews and medical records review.

Results: Maternal cortisol during pregnancy was not associated with risk for offspring schizophrenia. There was a significant interaction between 3rd trimester cortisol and case status on fetal growth. Specifically, cases exposed to higher 3rd trimester maternal cortisol had significantly decreased fetal growth compared to controls. In addition, these findings were restricted to male offspring.

Conclusions: Our results indicate that higher prenatal cortisol is associated with an intermediate phenotype linked to schizophrenia, fetal growth, but only among male offspring who developed schizophrenia. Findings were consistent with evidence that schizophrenia genes may disrupt placental functioning specifically for male fetuses, as well as findings that males are more vulnerable to maternal cortisol during pregnancy. Finally, results suggest that examining fetal sex and intermediate phenotypes may be important in understanding the mechanisms involved in prenatal contributors to schizophrenia.

Keywords: Birth weight; Cortisol; Fetal growth; Obstetric complications; Schizophrenia; Stress.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Birth Weight / physiology
  • Cohort Studies
  • Female
  • Fetal Development / physiology*
  • Humans
  • Hydrocortisone / blood*
  • Male
  • Phenotype
  • Pregnancy / blood*
  • Prenatal Exposure Delayed Effects / etiology*
  • Schizophrenia / etiology*
  • Sex Factors
  • Time Factors
  • Young Adult


  • Hydrocortisone