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Continued Exposure to Maternal Distress in Early Life Is Associated with an Increased Risk of Childhood Asthma

¹ Faculty of Pharmacy, ² Department of Community Health Sciences, Manitoba Centre for Health Policy, and ³ Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; ⁴ Department of Psychology, Faculty of Science, Dalhousie University, Halifax, Nova Scotia, Canada; and ⁵ Department of Immunology, Faculty of Medicine, and ⁶ School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence and requests for reprints should be addressed to Anita Kozyrskyj, Ph.D., 210 Pharmacy Building, Winnipeg, MB, Canada, R3T 2N2. E-mail: kozyrsk{at}cc.umanitoba.ca

Rationale: Evidence is emerging that exposure to maternal distress in early life plays a causal role in the development of childhood asthma.

Objectives: Because much of the data are from high-risk cohorts, we undertook a birth cohort study in a complete population of children to test this association.

Methods: Using Manitoba, Canada's, health care and prescription databases, this longitudinal study assessed the association between maternal distress during the first year of life and onward, and asthma at age 7 in a 1995 birth cohort of 13,907 children.

Measurements and Main Results: Maternal distress was defined on the basis of health care or prescription medication use for depression or anxiety. Asthma status was derived from health care and prescription records for asthma, using a definition validated by comparison to pediatric allergist diagnosis. Multiple logistic regression was used to determine the likelihood of asthma (odds ratio [OR], 95% confidence interval [95% CI]). Independent of well-known asthma risk factors, our population-based study of a non–high-risk cohort demonstrated an increased risk of childhood asthma (OR, 1.25; 95% CI, 1.01–1.55) among children exposed to continued maternal distress from birth until age 7. Exposure to maternal depression and anxiety limited to the first year of life did not have a demonstrable association with subsequent asthma. Of interest, we observed that the risk of asthma associated with continued maternal distress was increased in children living in high- versus low-income households (OR, 1.44; 95% CI, 1.12–1.85).

Conclusions: Maternal distress in early life plays a role in the development of childhood asthma, especially if it continues beyond the postpartum period.

Key Words: asthma • child • depression, postpartum

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Evidence is emerging from animal models and high-risk birth cohorts that exposure to maternal distress in early life plays a causal role in the development of childhood asthma. What This Study Adds to the Field In a population-based cohort of children born in 1995, maternal distress in early life was associated with an increased risk of childhood asthma, especially with distress that continued beyond the postpartum period.

 

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