Parental stress and childhood wheeze in a prospective cohort study.
BACKGROUND
Although studies indicate that psychological stress is linked with asthma morbidity, it is unknown whether stress is associated with the incidence of asthma symptoms.


METHODS
In a cohort of 5- to 6-year-old school children participating in the southern California Children's Health Study, we evaluated parent-reported wheeze in the child using a standardized questionnaire and perceived parental stress at study entry. Wheeze in the child was evaluated one year later. Analyses were restricted to children without asthma at study entry (N = 2,888, of whom 286 had wheeze at follow-up).


RESULTS
There was an increase in wheeze across an interquartile range of parent stress (odds ratio [OR] 1.18; 95% confidence interval [CI] 0.99, 1.42). Parent stress was associated with wheeze among children with no parental asthma (OR 1.24; CI 0.99, 1.55) and among boys (OR 1.34; CI 1.04, 1.74), but not among girls or children with parental asthma. Among boys with no parental asthma there was a strong dose-response relationship, and in the top quartile of stress the OR was 2.76 (CI 1.39, 5.51) compared to the bottom quartile.


CONCLUSIONS
Parental stress increases the risk of childhood wheeze among children with no parental history of asthma, especially among boys. These results suggest that the influence of psychosocial factors on asthma, such as stress and social environment, deserve increased attention.
Milam
Joel
J
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA. milam@usc.edu
McConnell
Rob
R
Yao
Ling
L
Berhane
Kiros
K
Jerrett
Michael
M
Richardson
Jean
J
D001249:Asthma / Q000235:genetics / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological