title: Maternal mental health and social support: effect on childhood atopic and non-atopic asthma symptoms.
abstract: BACKGROUND
  Atopic and non-atopic asthma have distinct risk factors and immunological mechanisms, and few studies differentiate between the impacts of psychosocial factors on the prevalence of these disease phenotypes. The authors aimed to identify whether the effect of maternal mental health on prevalence of asthma symptoms differs between atopic and non-atopic children, taking into account family social support.
  
  
  METHODS
  This is a cross-sectional study of 1013 children participating in the Social Change Allergy and Asthma in Latin America project. Psychosocial data were collected through a household survey utilising Self-Reporting Questionnaire and Medical Outcome Study Social Support Scale. Socioeconomic and wheezing information was obtained through the questionnaire of the International Study of Allergy and Asthma in Childhood, and level of allergen-specific IgE was measured to identify atopy. Polytomous logistic regression was used to estimate the association between maternal mental health, social support and atopic and non-atopic wheezing. Effect modification was evaluated through stratified polytomous regression according to social support level.
  
  
  RESULTS
  Maternal mental disorder had the same impact on atopic and non-atopic wheezing, even after adjusting for confounding variables. Affective, material and informational supports had protective effects on non-atopic asthma, and there is some evidence that social supports may act as a buffer for the impact of maternal mental disorder on non-atopic wheezing.
  
  
  CONCLUSIONS
  Poor maternal mental health is positively associated with wheezing, independent of whether asthma is atopic or non-atopic, but perception of high levels of social support appears to buffer this relationship in non-atopic wheezers only.
authors.affiliation: Department of Collective Health, Institute of Collective Health, Federal University of Bahia, Salvador, Brazil. marquesleticia@hotmail.com
authors.forename: Letícia
authors.initials: L
authors.lastname: Marques dos Santos
authors.forename: Darci
authors.initials: D
authors.lastname: Neves dos Santos
authors.forename: Laura Cunha
authors.initials: LC
authors.lastname: Rodrigues
authors.forename: Maurício Lima
authors.initials: ML
authors.lastname: Barreto
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D016241:Child of Impaired Parents; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008429:Maternal Welfare; D001523:Mental Disorders / Q000523:psychology; D008603:Mental Health; D015999:Multivariate Analysis; D016017:Odds Ratio; D010287:Parent-Child Relations; D015995:Prevalence; D012135:Respiratory Sounds / Q000209:etiology* / Q000276:immunology; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D007073:Immunoglobulin E