Maternal BMI, race/ethnicity modify associations between maternal stress, child asthma
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SAN FRANCISCO — Maternal prepregnancy BMI and race/ethnicity modified associations between maternal lifetime stress and asthma in offspring, according to data presented at the American Thoracic Society International Conference.
“Programming of child respiratory health begins in utero and is influenced by environmental factors, including maternal psychosocial stress,” Kecia N. Carroll, MD, MPH, professor of pediatrics and environmental medicine and public health at the Icahn School of Medicine at Mount Sinai, said during the presentation. “Maternal lifetime stress is associated with psychobiologic changes that can influence offspring asthma risk. However, investigations of maternal lifetime stress and child asthma have had mixed results.”
Carroll and colleagues evaluated the association between maternal lifetime stress and child asthma as well as the effect modification by maternal prepregnancy BMI and race/ethnicity using the Programming of Intergenerational Stress Mechanisms study, a prospective cohort study of 760 mother-child dyads. During mid-pregnancy, researchers recruited women in Boston from 2011 to 2013 and in New York from 2013 to 2020.
Maternal lifetime stress was characterized using the weighted Life Stressor Checklist-Revised score so participants could rate the impact of an experienced event over the past 12 months. Researchers assessed mother-child dyads by questionnaires every 4 months until the child was aged 30 months and then annually to evaluate asthma outcomes characterized by empirical report of ever asthma, provider diagnosis, asthma-specific medication use or hospitalization.
In the cohort, most women were Black (44.4%) or non-Black Hispanic (37.6%). Among Black and Hispanic women, there were higher prevalence of overweight (27.5% and 26.9%, respectively) and obesity (36.4% and 30.8%, respectively).
Overall, 21.3% of children born to this cohort developed asthma.
Black and Hispanic women had significantly higher prevalence of child asthma (18.1% and 19.6%, respectively) compared with white mothers (9.6%).
A higher Life Stressor Checklist-Revised score was associated with child asthma among women with obesity (OR = 1.96; 95% CI, 1.29-3) but not among women with overweight (OR = 0.86; 95% CI, 0.53-1.39) or women with under/normal weight (OR = 0.78; 95% CI, 0.53-1.17).
“We will continue enrollment in this cohort to obtain a larger number of dyads across the different racial/ethnic groups studied,” Carroll said. “We will continue following these children and assess asthma outcomes at older ages as well as lung function, and we will also work to delineate associated environmental factors as well as underlying mechanisms of association.”