Perinatal Maternal Mental Health Is Associated With Both Infections and Wheezing in Early Childhood

To examine associations between maternal mental health and early childhood wheezing and infections.

2314 mother-child pairs from an Italian birth cohort.

Maternal mental health was measured using the General Health Questionnaire-12 (GHQ-12), a validated screening instrument for non-psychotic psychiatric morbidity, at the end of pregnancy and one year after delivery. Child outcomes were assessed at 24 months. Wheezing between 12 and 24 months of age was assessed using validated ISAAC questions. Upper respiratory infections (URIs), lower respiratory tract infections (LRTIs), and diarrhea between 12 and 24 months of age were assessed by questionnaire.

Mothers reported that 10% of children had recurrent wheezing, 50% had URIs, 22% had LRTIs, and 24% had diarrhea between 12 and 24 months of age. Children whose mothers had higher GHQ-12 scores at the end of pregnancy and one-year after delivery had a greater risk of wheezing, respiratory infections, and diarrhea. However, the associations between persistently worse maternal mental health and these outcomes were no different than the associations between worse maternal mental health at the end of pregnancy only and these outcomes.

Children whose mothers had higher GHQ-12 scores at the end of pregnancy and 1 year after delivery had increased risk of wheezing, respiratory infections, and diarrhea.

This birth cohort study supports evidence from previous studies that maternal mental health is associated with greater risk of wheezing and infections in childhood, and suggests that worse maternal mental health precedes the development of wheezing and infection. Although the authors emphasize the associations between persistently higher maternal GHQ-12 scores (in both late pregnancy and 1 year postdelivery) and wheezing and infection outcomes, the associations between end-of-pregnancy GHQ-12 scores and these outcomes are similar, suggesting that maternal mental health at the end of pregnancy may be the more important predictor of early childhood outcomes, especially wheezing. Because of the associations with infections as well as wheezing, the authors speculate that the association between worse maternal mental health and child wheezing may be mediated by increased susceptibility to infections. Limitations include the potential for recall bias as mothers with worse mental health may recall health events of their children over the past year differently than those with better mental health. Together with other studies that have linked worse maternal mental health with childhood allergies, wheezing, asthma, and infections, this study suggests that interventions that improve maternal mental health may reduce the risk of these adverse health outcomes.