Asthma and lower airway disease
Mothers' anxiety during pregnancy is associated with asthma in their children

https://doi.org/10.1016/j.jaci.2009.01.042Get rights and content
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Background

Maternal stress in early life has been associated with the development of asthma in children, although it is unclear whether there are any critical periods of exposure. The association of asthma with prenatal exposure to maternal stress has not been reported.

Objective

We tested whether prenatal and postnatal anxiety and/or depression in pregnant women predicted the risk of their offspring developing asthma in childhood.

Methods

The Avon Longitudinal Study of Parents and Children is a population-based birth cohort recruited during pregnancy. Data were available on maternal anxiety scores and asthma at age 7½ years in 5810 children. Anxiety was assessed at 18 and 32 weeks of gestation by using the validated Crown-Crisp Experiential Index. Asthma was defined at age 7½ years as doctor-diagnosed asthma with current symptoms or treatment in the previous 12 months. Multivariable logistic regression was used to determine the association of prenatal anxiety with asthma (odds ratio; 95% CI).

Results

Independent of postnatal anxiety and adjusted for a number of likely confounders, there was a higher likelihood of asthma at age 7½ years (odds ratio, 1.64; 95% CI, 1.25-2.17) in children of mothers in the highest compared with lowest quartile of anxiety scores at 32 weeks of gestation, with evidence for a dose-response (P value for trend <0.001).

Conclusions

Maternal anxiety symptoms as an indicator of stress during fetal life may program the development of asthma during childhood.

Key words

Anxiety
pregnancy
prenatal programming
asthma
child

Abbreviations used

ALSPAC
Avon Longitudinal Study of Parents and Children
HPA
Hypothalamo-pituitary-adrenal
OR
Odds ratio

Cited by (0)

Disclosure of potential conflict of interest: A. J. Henderson receives grant support from the Medical Research Council, Wellcome Trust, and Asthma UK. C. Joinson receives grant support from the Economic and Social Research Council. The rest of the authors have declared that they have no conflict of interest.

The UK Medical Research Council, the Wellcome Trust, and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children. R.G. was supported by a project grant from Asthma UK.