Maternal Stressful Life Events During Pregnancy and Childhood Asthma and Wheeze

Prenatal maternal psychosocial stress has been linked to childhood asthma and wheeze. This study aims to better characterize the relationship between prenatal maternal stressful life events and subsequent development of childhood asthma and wheeze and evaluate factors that may mitigate this relationship.

The population included 2056 mother-child dyads enrolled in the National Institutes of Health ECHO-PATHWAYS consortium, which consisted of 3 cohorts. These cohorts were the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study, The Infant Development and Environment Study, and the Global Alliance to Prevent Prematurity and Stillbirth study.

This was a multicohort observational study in which maternal stressful life events experienced during pregnancy (PSLEs) were reported using the Pregnancy Risk Assessment Monitoring System Stressful Life Events questionnaire, and child asthma and wheeze between ages 4 and 6 years were reported using the International Study of Asthma and Allergies in Childhood questionnaire. Additional maternal and infant characteristics were collected at pre and postnatal appointments.

A median of 1 PSLE was reported. Parents reported current wheeze in 15% of children, ever asthma in 11%, current asthma in 12%, and strict asthma in 9%. Increasing number of PSLEs was associated with a significantly increased risk of current wheeze, and this association was stronger in male children compared with female children. There was no difference in PSLEs and respiratory outcomes when adjusting for duration of breastfeeding, maternal history of asthma, maternal childhood life events, or postnatal Childhood Opportunity Index.

These results support previous literature suggesting that PSLEs are associated with adverse childhood respiratory outcomes. Current wheeze specifically, which may represent uncontrolled or undiagnosed asthma, was more likely with increasing numbers of PSLE. The respiratory effects of PSLE were greater in male children compared with female children, and this may be because of differences in male versus female fetal development and placental function. Other factors including duration of breastfeeding, maternal exposure to childhood traumatic events, and maternal history of asthma did not have a modifying effect on respiratory outcomes.

Maternal stressful life events during pregnancy have an impact on respiratory outcomes in childhood, particularly in male children. Improved understanding of significant stressful events versus trauma to identify and alleviate factors may lead to improved health of both mother and child.