Maternal mental health and social support: effect on childhood atopic and non-atopic asthma symptoms
- Letícia Marques dos Santos1,
- Darci Neves dos Santos1,
- Laura Cunha Rodrigues2,
- Maurício Lima Barreto1
- 1Department of Collective Health, Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- 2London School of Hygiene and Tropical Medicine, London, UK
- Correspondence to Dr Letícia Marques dos Santos, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n°, Campus Universitário Canela, Salvador, Bahia 40110040, Brazil.
Contributors LMdS was involved in data analysis and interpretation as well as in writing the first draft of the study. DNdS was involved in the study planning and design, data analysis and interpretation and helped to review the study draft. LCR was involved in the study planning and design, data analysis and interpretation and helped to review the study draft. MLB, principal investigator of the main study from which this present study was derived, was involved in the study planning and design, data interpretation and helped to review the study draft.
- Accepted 8 February 2012
- Published Online First 11 April 2012
Background Atopic and non-atopic asthma have distinct risk factors and immunological mechanisms, and few studies differentiate between the impacts of psychosocial factors on the prevalence of these disease phenotypes. The authors aimed to identify whether the effect of maternal mental health on prevalence of asthma symptoms differs between atopic and non-atopic children, taking into account family social support.
Methods This is a cross-sectional study of 1013 children participating in the Social Change Allergy and Asthma in Latin America project. Psychosocial data were collected through a household survey utilising Self-Reporting Questionnaire and Medical Outcome Study Social Support Scale. Socioeconomic and wheezing information was obtained through the questionnaire of the International Study of Allergy and Asthma in Childhood, and level of allergen-specific IgE was measured to identify atopy. Polytomous logistic regression was used to estimate the association between maternal mental health, social support and atopic and non-atopic wheezing. Effect modification was evaluated through stratified polytomous regression according to social support level.
Results Maternal mental disorder had the same impact on atopic and non-atopic wheezing, even after adjusting for confounding variables. Affective, material and informational supports had protective effects on non-atopic asthma, and there is some evidence that social supports may act as a buffer for the impact of maternal mental disorder on non-atopic wheezing.
Conclusion Poor maternal mental health is positively associated with wheezing, independent of whether asthma is atopic or non-atopic, but perception of high levels of social support appears to buffer this relationship in non-atopic wheezers only.
- mental health psychological symptoms
- social support
- psychosocial factors
- psychosocial epidemiology
- mental health
Funding Wellcome Trust, UK, HCPC Latin American Centres of Excellence Programme (ref 072405/Z/03/Z). The funders had no role in study design, data collection and analysis, the decision to publish or the preparation of the manuscript.
Competing interests None.
Ethics approval The study was approved by the National Ethics Committee in 2005, registration number 047-05/CEP-ISC FR-78168.
Provenance and peer review Not commissioned; externally peer reviewed.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode