Study Title:

Pregnancy Stress and Asthma Risk in Offspring

Study Abstract

Background
Prior research has linked maternal prenatal and postnatal mental health with the subsequent development of asthma in children. However, this relationship has not been examined in inner-city African Americans and Hispanics, populations at high risk for asthma.

Objective
To determine the relationship of maternal demoralization with wheeze, specific wheeze phenotypes, and seroatopy among children living in a low-income, urban community.

Methods
African American and Dominican women aged 18 to 35 years residing in New York City (the Bronx and Northern Manhattan) were recruited during pregnancy (n = 279). Maternal demoralization (ie, psychological distress) was measured both prenatally and postnatally by validated questionnaire. Outcomes included wheeze, transient (birth to 2.5 years of age), late onset (3–5 years), and persistent (birth to 5 years of age), evaluated via questionnaire and total and indoor allergen specific IgE (at birth and ages 2, 3, and 5 years). Logistic regression with generalized estimating equations assessed the association of demoralization with wheeze and atopy. Multinomial regression explored associations between demoralization and specific wheeze phenotypes.

Results
Prenatal demoralization significantly predicted overall wheeze (adjusted odds ratio OR, 1.66; 95% confidence interval [CI], 1.29–2.14), transient wheeze (OR, 2.25; 95% CI, 1.34–3.76), and persistent wheeze (OR, 2.69; 95% CI, 1.52–4.77). No association was found between demoralization and IgE after adjustment (total IgE: OR, 1.04; 95% CI, 0.74–1.45; any specific IgE: OR, 0.96; 95% CI, 0.57–1.60).

Conclusions
In this inner-city cohort, prenatal demoralization was associated with transient and persistent wheeze. Understanding how maternal demoralization influences children's respiratory health may be important for developing effective interventions among disadvantaged populations.

From press release:

Anxiety, stress and depression during pregnancy may lead to a greater risk of asthma for your child, according to researchers at Columbia University's Mailman School of Public Health. Study results are published in the July issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

"Approximately 70% of mothers who said they experienced high levels of anxiety or depression while they were pregnant reported their child had wheezed before age 5," said Marilyn Reyes, senior research worker at the Mailman School of Public Health's Columbia Center for Children's Environmental Health (CCCEH), and lead author of the study. "Understanding how maternal health affects a child's respiratory health is important in developing effective strategies to prevent asthma."

The study of 279 inner-city African-American and Hispanic women was conducted before, during pregnancy and after birth. The findings support a growing body of research showing that exposures can influence the risk of developing asthma. While somewhat similar findings have been reported in non-minority populations, this study is the first to report an association between prenatal psychological stress and wheeze in minority populations.

"The symptoms of pediatric asthma can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies," said allergist/pulmonologist Rachel Miller, MD, Co-Deputy Director of CCCEH and study senior author. "While low-income families experience stressors from many sources that may contribute to adverse health outcomes in children, understanding how children's health may be influenced by these factors is an important step in developing effective interventions."

Common asthma symptoms include:

•Coughing, especially at night
•Wheezing or whistling sound, especially when breathing out
•Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly
•Frequent colds that settle in the chest
The study was supported by a grant of the National Institute of Environmental Health Sciences and the Environmental Protection Agency.

Study Information

Marilyn Reyes, Matthew S. Perzanowski, Robin M. Whyatt, Elizabeth A. Kelvin, Andrew G. Rundle, Diurka M. Diaz, Lori Hoepner, Frederica P. Perera, Virginia Rauh, Rachel L. Miller.
Relationship between maternal demoralization, wheeze, and immunoglobulin E among inner-city children.
Annals of Allergy, Asthma & Immunology
2011 April
Columbia University's Mailman School of Public Health.

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