Maternal Distress During Pregnancy and Recurrence in Early Childhood Predicts Atopic Dermatitis and Asthma in Childhood

Aaron P van der Leek; Salma Bahreinian; Mariette Chartier; Matthew E Dahl; Meghan B Azad; Marni D Brownell; Anita L Kozyrskyj

doi:10.1016/j.chest.2020.01.052

Maternal Distress During Pregnancy and Recurrence in Early Childhood Predicts Atopic Dermatitis and Asthma in Childhood

Chest. 2020 Jul;158(1):57-67. doi: 10.1016/j.chest.2020.01.052. Epub 2020 Mar 12.

Authors

Aaron P van der Leek¹, Salma Bahreinian¹, Mariette Chartier², Matthew E Dahl², Meghan B Azad³, Marni D Brownell², Anita L Kozyrskyj⁴

Affiliations

¹ Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada.
³ Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
⁴ Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada. Electronic address: kozyrsky@ualberta.ca.

PMID: 32173490
DOI: 10.1016/j.chest.2020.01.052

Abstract

Background: Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied.

Research question: Does the likelihood of asthma and atopic dermatitis in children increase when they are exposed to maternal distress pre- and postnatally in a sex-specific manner?

Study design and methods: Using data from a provincial newborn screen and health-care database for 12,587 children born in 2004, maternal distress (depression or anxiety) was defined as prenatal, self-limiting, recurrent, or late-onset postpartum. Atopic dermatitis (AD) and asthma at ages 5 years and 7 years of age were diagnosed by using hospitalization, physician visit, or prescription records. Associations between maternal distress and childhood asthma and AD were determined by using multiple logistic regression.

Results: After adjusting for risk factors, a significant association between maternal prenatal (OR, 1.27; 95% CI, 1.11-1.46), recurrent postpartum (OR, 1.28; 95% CI, 1.11-1.48), and late-onset postpartum (OR, 1.19, 95% CI, 1.06-1.34) distress was found with AD at age 5 years. Asthma at age 7 years was also associated with maternal prenatal distress (OR, 1.57; 95% CI, 1.29-1.91) and late-onset postnatal distress (OR, 1.22; 95% CI, 1.01-1.46). Self-limiting postnatal distress was not found to be a risk factor for either atopic condition. Associations with AD or asthma were of a similar magnitude in boys and girls; the exception was recurrent postnatal distress, which increased risk for asthma in boys only.

Interpretation: This population-based study provides evidence for sex-specific associations between maternal prenatal and postnatal distress, as well as the development of AD and asthma. The findings support recommendations for greater psychosocial support of mothers during pregnancy and early childhood to prevent childhood atopic disease.

Keywords: asthma; atopic dermatitis; maternal anxiety; maternal depression; newborn respiratory distress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Asthma / diagnosis
Asthma / epidemiology*
Child
Child, Preschool
Cohort Studies
Dermatitis, Atopic / diagnosis
Dermatitis, Atopic / epidemiology*
Female
Humans
Male
Pregnancy
Pregnancy Complications / epidemiology*
Pregnancy Complications / psychology*
Prevalence
Recurrence
Sex Factors
Stress, Psychological / complications*
Stress, Psychological / epidemiology*
Young Adult