Longitudinal Assessment of Maternal Depression and Early Childhood Asthma and Wheeze: Effect Modification by Child Sex

To examine associations between maternal depression and childhood asthma and wheeze and explore sex differences.

Pregnant women (at least 18 years old and <20 weeks gestation) receiving health service and prenatal care through the Mexican Social Security System (Instituto Mexicano del Seguro Social) between July 2007 and February 2011 were recruited into the Programming Research in Obesity, Growth, Environment and Social Stressors study. Mother-child dyads were actively followed.

This longitudinal study included 601 mother-child dyads from the Programming Research in Obesity, Growth, Environment and Social Stressors cohort. Participants completed the Edinburgh Depression Scale questionnaire during the second or third trimester of pregnancy, and the 1-, 6-, 12-, 18-, 24-, and 48-month postnatal study visits. Respiratory outcomes were assessed through administration of the International Study of Asthma and Allergies in Childhood questionnaire at the 48-month and 72-month visit.

Most mothers studied were of lower socioeconomic status (52%), with mean age of 27 years, and had no more than high school education (77%). Prenatal depression was reported in 16% of participants, postpartum depression observed in 25% of participants, and recurrent depression in 17% of participants. Postpartum depression was associated with increased risk of any current wheeze (risk ratio [RR]: 1.68, 95% confidence interval [CI]: 1.09–2.59) and any ever asthma (RR: 2.04, 95% CI: 1.01–4.11). Similarly, recurrent depression was associated with increased risk of ever wheeze (RR: 1.48, 95% CI: 1.07–2.04), current wheeze (RR: 2.41, 95% CI: 1.02–5.84). Females saw increased risk of current wheeze when born to mothers with reported recurrent depression (RR: 4.34, 95% CI: 2.02–9.317) as well as to mothers with postpartum depression (RR: 2.47, 95% CI: 0.72–8.44).

Although no significant findings were observed regarding prenatal depression, postpartum depression and recurrent depression were associated with a higher risk of wheeze and asthma in the early childhood period. A higher risk of wheeze was observed in females as compared with males.

Although this study is significantly limited by recall bias, this longitudinal study contributes to growing evidence of an association between maternal depression and early childhood asthma risk. To further elucidate this association and in the recent context of increased mental health issues such as depression and anxiety worldwide, future research should explore this association in the context of factors such as socioeconomic status, self-efficacy, and quality of life. Findings of this study also highlight the importance of postpartum depression screening during well child visits.