• Sima K Ramratnam, Alexandre Lockhart, Cynthia M Visness, Agustin Calatroni, Daniel J Jackson, Peter J Gergen, Leonard B Bacharier, George T O'Connor, Megan T Sandel, Meyer Kattan, Robert A Wood, James E Gern, and Inner-City Asthma Consortium.
• Department of Pediatrics, University of Wisconsin - Madison, Madison, Wis. Electronic address: sramratnam@wisc.edu.
• J. Allergy Clin. Immunol. 2021 Jul 1; 148 (1): 120-127.

BackgroundPrenatal and early-life exposure to maternal stress and depression is linked to development of recurrent wheezing in young children.ObjectiveWe sought to determine whether maternal stress and depression in early life are associated with nonatopic wheezing phenotype in urban children.MethodsThe Urban Environment and Childhood Asthma Study examined a birth cohort of children at high risk for asthma in low-income neighborhoods. Prenatal and postnatal (through age 3 years) maternal stress and depression scores were compared with respiratory phenotypes through age 10 years (multinomial regression), self-reported colds (linear regression), and detection of respiratory viruses (Poisson regression).ResultsScores for maternal depression, and, to a lesser extent, maternal perceived stress, were positively related to multiple wheezing phenotypes. In particular, cumulative measures of maternal depression in the first 3 years were related to the moderate-wheeze-low-atopy phenotype (odds ratio, 1.13; [1.05, 1.21]; P < .01). Considering indicators of respiratory health that were used to identify the phenotypes, there were multiple positive associations between early-life scores for maternal stress and depression and increased wheezing illnesses, but no consistent relationships with lung function and some inverse relationships with allergic sensitization. Cumulative maternal stress and depression scores were associated with cumulative number of respiratory illnesses through age 3 years.ConclusionsAmong high-risk, urban children, maternal stress and depression in early life were positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype. These results suggest that treating stress and depression in expectant and new mothers could reduce viral respiratory illnesses and recurrent wheeze during the preschool years and some forms of childhood asthma.Copyright © 2021 American Academy of Allergy, Asthma & Immunology. All rights reserved.

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