Evidence map›Paper›PMID 34203208›Full record

ArticleJournal of clinical medicine2021

Being Born in Winter-Spring and at Around the Time of an Influenza Pandemic Are Risk Factors for the Development of Schizophrenia: The Apna Study in Navarre, Spain.

Miguel A Alvarez-Mon, Sara Guillen-Aguinaga, Victor Pereira-Sanchez, Luc Onambele, Moad J Al-Rahamneh, Antonio Brugos-Larumbe, Francisco Guillen-Grima, Felipe Ortuño

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.6field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Birth seasonality and height in patients with schizophrenia: a multi-institutional cohort study.European archives of psychiatry and clinical neuroscience · 2026
    Article
  2. Article
  3. Article
  4. Review
  5. Neurogenesis decreases in the offspring of mothers infected with influenza A virus.Frontiers in cellular and infection microbiology · 2025
    Article
  6. Maternal Influenza and Offspring Neurodevelopment.Current issues in molecular biology · 2024
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 4 countries.

Miguel A Alvarez-MonDepartment of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain.ORCID 0000-0002-1987-0394
Sara Guillen-AguinagaPrimary Health Care, Navarra Health Service, 31008 Pamplona, Spain.ORCID 0000-0003-4748-9520
Victor Pereira-SanchezDepartment of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain.ORCID 0000-0002-2576-1549
Luc OnambeleÉcole des Sciences de la Santé, Université Catholique d'Afrique Centrale, Yaoundé, Cameroon.
Moad J Al-RahamnehThe Eastern Mediterranean Public Health Network (EMPHNET), Global Health Development (GHD), Amman 11195, Jordan.
Antonio Brugos-LarumbePrimary Health Care, Navarra Health Service, 31008 Pamplona, Spain.
Francisco Guillen-GrimaDepartment of Health Sciences, Public University of Navarra (UPNA), 31008 Pamplona, Spain.ORCID 0000-0001-9749-8076
Felipe OrtuñoDepartment of Psychiatry and Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Spain.
Navarre Institute of Health Research · ESUniversidad de Navarra · ESCatholic University of Central Africa · CMEastern Mediterranean Public Health Network · JONew York University · USUniversidad de Alcalá · ES

Funding

Gobierno de Navarra Gobierno de Navarra
6 · The paper itself

Abstract

backgroundWe analyzed the relationship between the prevalence of schizophrenia and the season of birth and gestation during a period of an influenza pandemic.

methodsCross-sectional analysis of a prospective population-based cohort of 470,942 adults. We fitted multivariant logistic regression models to determine whether the season of birth and birth in an influenza-pandemic year (1957, 1968, 1977) was associated with schizophrenia.

results2077 subjects had been diagnosed with schizophrenia. Logistic regression identified a significantly greater prevalence of schizophrenia in men than in women (OR = 1.516, CI 95% = 1.388-1.665); in those born in the winter or spring than in those born in the summer or autumn (OR = 1.112, CI 95% = 1.020-1.212); and in those born in a period of an influenza pandemic (OR = 1.335, CI 95% = 1.199-1.486). The increase in risk was also significant when each influenza pandemic year was analyzed separately. However, neither month of birth nor season of birth, when each of the four were studied individually, were associated with a statistically significant increase in that risk.

conclusionsThe winter-spring period and the influenza pandemics are independent risk factors for developing schizophrenia. This study contradicts many previous studies and thus revitalizes a locked debate in understanding the neurodevelopmental hypothesis of this disorder.

Indexed as

influenza pandemicneurodevelopmental hypothesisschizophreniaseason of birth

Identifiers

PMID34203208
PMCPMC8267856
OpenAlexW3176935101

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.