Turcotte-Tremblay Anne-Marie, Lim Robert, Laplante David P, Kobzik Lester, Brunet Alain, King Suzanne
University of Montreal Hospital Research Centre, Montreal, QC, Canada H2X 0A9 ; University of Montreal, Montreal, QC, Canada H3N 1X9 ; Douglas Hospital Research Center, Montreal, QC, Canada H4H 1R3.
Harvard School of Public Health, Boston, MA 02115, USA ; Boston Children's Hospital, Boston, MA 02115, USA.
Biomed Res Int. 2014;2014:201717. doi: 10.1155/2014/201717. Epub 2014 May 8.
Little is known about how prenatal maternal stress (PNMS) influences risks of asthma in humans. In this small study, we sought to determine whether disaster-related PNMS would predict asthma risk in children. In June 1998, we assessed severity of objective hardship and subjective distress in women pregnant during the January 1998 Quebec Ice Storm. Lifetime asthma symptoms, diagnoses, and corticosteroid utilization were assessed when the children were 12 years old (N = 68). No effects of objective hardship or timing of the exposure were found. However, we found that, in girls only, higher levels of prenatal maternal subjective distress predicted greater lifetime risk of wheezing (OR = 1.11; 90% CI = 1.01-1.23), doctor-diagnosed asthma (OR = 1.09; 90% CI = 1.00-1.19), and lifetime utilization of corticosteroids (OR = 1.12; 90% CI = 1.01-1.25). Other perinatal and current maternal life events were also associated with asthma outcomes. Findings suggest that stress during pregnancy opens a window for fetal programming of immune functioning. A sex-based approach may be useful to examine how prenatal and postnatal environments combine to program the immune system. This small study needs to be replicated with a larger, more representative sample.
关于产前母亲压力（PNMS）如何影响人类患哮喘的风险，我们知之甚少。在这项小型研究中，我们试图确定与灾难相关的PNMS是否会预测儿童患哮喘的风险。1998年6月，我们评估了在1998年1月魁北克冰暴期间怀孕的女性所面临的客观困难和主观痛苦的严重程度。当这些孩子12岁时（N = 68），评估了他们一生的哮喘症状、诊断情况以及皮质类固醇的使用情况。未发现客观困难或暴露时间的影响。然而，我们发现，仅在女孩中，产前母亲较高水平的主观痛苦预示着更高的一生喘息风险（OR = 1.11；90% CI = 1.01 - 1.23）、医生诊断的哮喘（OR = 1.09；90% CI = 1.00 - 1.19）以及一生皮质类固醇的使用情况（OR = 1.12；90% CI = 1.01 - 1.25）。其他围产期和当前母亲的生活事件也与哮喘结局相关。研究结果表明，孕期压力为胎儿免疫功能编程打开了一扇窗口。基于性别的方法可能有助于研究产前和产后环境如何共同对免疫系统进行编程。这项小型研究需要用更大、更具代表性的样本进行重复。
