title: Continued exposure to maternal distress in early life is associated with an increased risk of childhood asthma.
abstract: BACKGROUND
  Evidence is emerging that exposure to maternal distress in early life plays a causal role in the development of childhood asthma.
  
  
  OBJECTIVE
  Because much of the data are from high-risk cohorts, we undertook a birth cohort study in a complete population of children to test this association.
  
  
  METHODS
  Using Manitoba, Canada's, health care and prescription databases, this longitudinal study assessed the association between maternal distress during the first year of life and onward, and asthma at age 7 in a 1995 birth cohort of 13,907 children.
  
  
  RESULTS
  Maternal distress was defined on the basis of health care or prescription medication use for depression or anxiety. Asthma status was derived from health care and prescription records for asthma, using a definition validated by comparison to pediatric allergist diagnosis. Multiple logistic regression was used to determine the likelihood of asthma (odds ratio [OR], 95% confidence interval [95% CI]). Independent of well-known asthma risk factors, our population-based study of a non-high-risk cohort demonstrated an increased risk of childhood asthma (OR, 1.25; 95% CI, 1.01-1.55) among children exposed to continued maternal distress from birth until age 7. Exposure to maternal depression and anxiety limited to the first year of life did not have a demonstrable association with subsequent asthma. Of interest, we observed that the risk of asthma associated with continued maternal distress was increased in children living in high- versus low-income households (OR, 1.44; 95% CI, 1.12-1.85).
  
  
  CONCLUSIONS
  Maternal distress in early life plays a role in the development of childhood asthma, especially if it continues beyond the postpartum period.
authors.affiliation: Faculty of Pharmacy, Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada. kozyrsk@cc.umanitoba.ca
authors.forename: Anita L
authors.initials: AL
authors.lastname: Kozyrskyj
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Mai
authors.forename: Patrick
authors.initials: P
authors.lastname: McGrath
authors.forename: Kent T
authors.initials: KT
authors.lastname: Hayglass
authors.forename: Allan B
authors.initials: AB
authors.lastname: Becker
authors.forename: Brian
authors.initials: B
authors.lastname: Macneil
mesh_terms: D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology; D001249:Asthma / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors