title: Prenatal and postnatal stress and wheeze in Mexican children: Sex-specific differences.
abstract: BACKGROUND
  Increasing evidence links early-life exposure to psychosocial stress with adverse childhood respiratory outcomes. The influence of exposure timing has not been completely elucidated.
  
  
  OBJECTIVE
  To examine the association between prenatal and postnatal maternal stress and wheeze in 417 children enrolled in a prospective birth cohort in Mexico City.
  
  
  METHODS
  Maternal negative life event (NLE) scores were ascertained in the second or third trimester of pregnancy and at the 48-month postnatal visit. Children's respiratory outcomes, caregiver report of ever wheeze, and wheeze in the past 12 months were obtained from the International Study of Asthma and Allergies in Childhood survey administered at 48 months. Associations between prenatal and postnatal NLE scores and wheeze were analyzed using a modified Poisson regression approach adjusting for covariates.
  
  
  RESULTS
  In separate models, higher maternal psychosocial stress during pregnancy (relative risk [RR], 1.12; 95% CI, 1.00-1.26) and postnatally (RR, 1.21; 95% CI, 1.08-1.35) were associated with increased risk of wheeze in the past 12 months with an evident exposure-response relationship. There was a significant interaction between postnatal stress and sex in relation to current wheeze. In a sex-stratified model, the association between postnatal stress and risk of wheeze in the past 12 months was stronger in girls (RR, 1.35; 95% CI, 1.13-1.61) than in boys (RR, 1.11; 95% CI, 0.97-1.27) (P for interaction = .04).
  
  
  CONCLUSIONS
  Prenatal and postnatal stress in mothers was associated with wheeze in preschool-aged children, and the effect of postnatal stress was stronger in girls. Understanding the temporal- and sex-specific effects of stress may better inform prevention strategies.
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Rosa
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Allan C
authors.initials: AC
authors.lastname: Just
authors.affiliation: National Institute of Public Health, Cuernavaca, Mexico.
authors.forename: Marcela
authors.initials: M
authors.lastname: Tamayo Y Ortiz
authors.affiliation: National Institute of Perinatology, Mexico DF, Mexico.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Schnaas
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Katherine
authors.initials: K
authors.lastname: Svensson
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Wright
authors.affiliation: National Institute of Public Health, Cuernavaca, Mexico.
authors.forename: Martha María
authors.initials: MM
authors.lastname: Téllez Rojo
authors.affiliation: Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: rosalind.wright@mssm.edu.
authors.forename: Rosalind J
authors.initials: RJ
authors.lastname: Wright
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects; D008800:Mexico; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies; D012135:Respiratory Sounds; D012306:Risk; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D055815:Young Adult
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