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Prenatal stress increased child’s risk for asthma, eczema
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Women who experience adverse life events during the second half of gestation are more likely to increase a child’s risk for atopic disorders, asthma and eczema, according to researchers.
“We report that the risk for children’s asthma, eczema, or allergic rhinitis at the age of 14 years increases in response to life events experienced by the pregnant woman between gestational weeks 18 and 34,” Isabel R. V. Hartwig, MSc, of the department of obstetrics and fetal medicine at the University Medical Centre Hamburg-Eppendorf, in Germany, and colleagues wrote. “Hence, our recent observations amend and strengthen the concept of fetal programming of allergic diseases in response to prenatal challenges, for example, stress.”
The researchers calculated the odds of asthma, eczema, and/or allergic rhinitis in children aged 6 or 14 years (n=1,587) from the Western Australian Pregnancy Cohort (Raine) Study, depending on their mother’s exposure to adverse life events, including a residential move, economic or marital problems, or job loss at 18 and 34 weeks gestation. Complete data were available for 994 children.
Asthma at ages 6 or 14 years was significantly associated with prenatal maternal life events between gestational weeks 18 and 34 (OR=2.09; 95% CI, 1.22-3.54). The risk for asthma in response to prenatal life events was significant by age 14 years after adjustments for confounders (one life event: OR=2.24; 95% CI, 1.33-3.75; two: OR=1.96; 95% CI, 1.01-3.79; three or more: OR=1.81; 95% CI, 0.74-4.46), but not at age 6 years (one life event: OR=1.1; 95% CI, 0.72-1.66; two: OR=1.34; 95% CI, 0.8-2.24; three or more: OR=0.99; 95% CI, 0.47-2.08).
The association between prenatal life events and a significantly increased risk for asthma or eczema was only established for children aged 14 years, but not 6 years.
Disclosure: See the study for a full list of relevant financial disclosures.
Perspective
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Mitchell H. Grayson , MD, FAAAAI, FACAAI
The asthma association was only observed at age 14 years. If mothers had a life event and it was between 18 and 34 weeks of gestation, children were more likely to have asthma specifically if their mother didn’t have asthma, which is a different finding.
From my viewpoint, the interesting part of this study is the suggestion that stressors during the 2nd and 3rd trimester may have an effect on late development of asthma. This is certainly not a slam dunk and it requires several more studies to verify. It’s also interesting that the association is with mothers who do not have asthma, which makes you wonder if stress-related asthma is actually mechanistically different than the asthma that which we normally see by 6 years of age.
The big picture suggests that stress during pregnancy is not a good thing, which is something we already know, however, this study suggests that this stress could drive the development of atopic disease – and in particular asthma. Until we understand the mechanism, these findings are not going to change clinical practice. This study needs to be repeated in other populations.
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