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J Allergy Clin Immunol. Apr 2009; 123(4): 847–853.e11.
PMCID: PMC2726292
Mothers' anxiety during pregnancy is associated with asthma in their children
Hannah Cookson,a Raquel Granell,b Carol Joinson,c Yoav Ben-Shlomo,b and A. John Hendersonc*
aDepartment of Internal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
bDepartment of Social Medicine, University of Bristol, Bristol, United Kingdom
cDepartment of Community-Based Medicine, University of Bristol, Bristol, United Kingdom
A. John Henderson: a.j.henderson/at/bris.ac.uk
*Reprint requests: John Henderson, ALSPAC, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom. a.j.henderson/at/bris.ac.uk
Received October 14, 2008; Revised January 9, 2009; Accepted January 12, 2009.
This document was posted here by permission of the publisher. At the time of the deposit, it included all changes made during peer review, copy editing, and publishing. The U. S. National Library of Medicine is responsible for all links within the document and for incorporating any publisher-supplied amendments or retractions issued subsequently. The published journal article, guaranteed to be such by Elsevier, is available for free, on ScienceDirect, at: http://dx.crossref.org/10.1016/j.jaci.2009.01.042
Abstract
Background
Maternal stress in early life has been associated with the development of asthma in children, although it is unclear whether there are any critical periods of exposure. The association of asthma with prenatal exposure to maternal stress has not been reported.
Objective
We tested whether prenatal and postnatal anxiety and/or depression in pregnant women predicted the risk of their offspring developing asthma in childhood.
Methods
The Avon Longitudinal Study of Parents and Children is a population-based birth cohort recruited during pregnancy. Data were available on maternal anxiety scores and asthma at age 7½ years in 5810 children. Anxiety was assessed at 18 and 32 weeks of gestation by using the validated Crown-Crisp Experiential Index. Asthma was defined at age 7½ years as doctor-diagnosed asthma with current symptoms or treatment in the previous 12 months. Multivariable logistic regression was used to determine the association of prenatal anxiety with asthma (odds ratio; 95% CI).
Results
Independent of postnatal anxiety and adjusted for a number of likely confounders, there was a higher likelihood of asthma at age 7½ years (odds ratio, 1.64; 95% CI, 1.25-2.17) in children of mothers in the highest compared with lowest quartile of anxiety scores at 32 weeks of gestation, with evidence for a dose-response (P value for trend <0.001).
Conclusions
Maternal anxiety symptoms as an indicator of stress during fetal life may program the development of asthma during childhood.
Key words: Anxiety, pregnancy, prenatal programming, asthma, child
Abbreviations used: ALSPAC, Avon Longitudinal Study of Parents and Children; HPA, Hypothalamo-pituitary-adrenal; OR, Odds ratio