title: Maternal mental health and childhood asthma among Puerto Rican youth: the role of prenatal smoking.
abstract: BACKGROUND
  Childhood asthma is a major public health problem, with mainland and island Puerto Rican children having the highest asthma rates of any ethnic group in the United States.
  
  
  OBJECTIVE
  To examine the relationship between maternal mental health problems, prenatal smoking, and risk of asthma among children in Puerto Rico and the Bronx, New York.
  
  
  METHODS
  A cross-sectional community-based study was conducted in the South Bronx in New York City and the San Juan Standard Metropolitan Area in Puerto Rico. Participants were Puerto Rican children 5 to 13 years of age and their adult caretakers with probability samples of children 5 to 13 years of age and their caregivers drawn at two sites: the South Bronx in New York City (n = 1,135) and San Juan and Caguas, Puerto Rico (n = 1,351).
  
  
  METHODS
  Self-reported maternal mental health, prenatal smoking, and rates of childhood asthma. Results. Maternal mental health problems were associated with significantly higher levels of prenatal smoking, compared with that among women without mental health problems (p < 0.0001). Both maternal mental health problems and prenatal smoking appear to make a contribution to increased odds of asthma among youth. After adjusting for prenatal smoking, the relationship between maternal mental health problems and childhood asthma was no longer statistically significant.
  
  
  CONCLUSIONS
  Previous research suggests children of Puerto Rican descent are especially vulnerable to asthma. Our results suggest that maternal mental health problems and prenatal smoking are both associated with increased odds of asthma among Puerto Rican youth and that prenatal smoking may partly explain the observed relationship between maternal psychopathology and childhood asthma. Future longitudinal and geographically diverse epidemiological studies may help to identify the role of both maternal mental health problems and prenatal smoking in the health disparities in childhood asthma.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. rdg66@columbia.edu
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Ortega
authors.forename: Hector R
authors.initials: HR
authors.lastname: Bird
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008429:Maternal Welfare / Q000208:ethnology* / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000150:complications; D008603:Mental Health; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology; D011647:Puerto Rico / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology / Q000523:psychology*