Prenatal and postnatal stress and asthma in children: Temporal- and sex-specific associations

Publication date: Available online 4 March 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Alison Lee, Yueh-Hsiu Mathilda Chiu, Maria José Rosa, Calvin Jara, Robert O. Wright, Brent A. Coull, Rosalind J. Wright
BackgroundTemporal- and sex-specific effects of perinatal stress have not been examined for childhood asthma.ObjectivesWe examined associations between prenatal and/or postnatal stress and children's asthma (n = 765) and effect modification by sex in a prospective cohort study.MethodsMaternal negative life events were ascertained prenatally and postpartum. Negative life event scores were categorized as 0, 1 to 2, 3 to 4, or 5 or greater to assess exposure-response relationships. We examined effects of prenatal and postnatal stress on children's asthma by age 6 years, modeling each as independent predictors, mutually adjusting for prenatal and postnatal stress, and finally considering interactions between prenatal and postnatal stress. Effect modification by sex was examined in stratified analyses and by fitting interaction terms.ResultsWhen considering stress in each period independently, among boys, a dose-response relationship was evident for each level increase on the ordinal scale prenatally (odds ratio [OR], 1.38; 95% CI, 1.06-1.79; P value for trend = .03) and postnatally (OR, 1.53; 95% CI, 1.16-2.01; P value for trend = .001); among girls, only the postnatal trend was significant (OR, 1.60; 95% CI, 1.14-2.22; P value for trend = .005). Higher stress in both the prenatal and postnatal periods was associated with increased odds of receiving a diagnosis of asthma in girls (OR, 1.37; 95% CI, 0.98-1.91; Pinteraction = .07) but not boys (OR, 1.08; 95% CI, 0.82-1.42; Pinteraction = .61).ConclusionsAlthough boys were more vulnerable to stress during the prenatal period, girls were more affected by postnatal stress and cumulative stress across both periods in relation to asthma. Understanding sex and temporal differences in response to early-life stress might provide unique insight into the cause and natural history of asthma.



from #ENT via xlomafota13 on Inoreader http://ift.tt/1UHmSRO
via IFTTT