Radhakrishnan Dhenuka, Shariff Salimah Z, To Teresa
a Department of Pediatrics , Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada.
b Department of Pediatrics , University of Ottawa , Ottawa , Ontario , Canada.
J Asthma. 2019 Apr;56(4):395-403. doi: 10.1080/02770903.2018.1466313. Epub 2018 Jul 9.
We aimed to determine whether maternal mental health service use during pregnancy, a potential proxy measure of prenatal maternal stress, is associated with the development of asthma in a large population-based sample of children. We hypothesized that children born to mothers with mental health service use during pregnancy would have a higher incidence of childhood asthma.
Health administrative data from Ontario, Canada (population >13 million) was used to identify pairs of mothers linked with their children born between April 1, 2001 to March 31, 2002. Descriptive statistics were used to compare the cumulative incidence of asthma by age 12 years in children whose mothers did or did not have prenatal mental health service use. Multivariable logistic regression was used to estimate the association between prenatal maternal mental health service use and childhood asthma incidence, after adjusting for the child's sex, residency (rural vs. urban), socioeconomic status, comorbid health conditions, low birthweight, and maternal history of asthma.
In a population-based sample of 122,333 children, those born to mothers with mental health service use during pregnancy had increased odds of developing asthma (odds ratio: 1.16, 95% confidence intervals: 1.12, 1.20, p < 0.001).
Prenatal maternal mental health service use is an independent risk factor for the development of asthma in childhood. This supports growing evidence for the importance of in utero exposure to maternal stress factors in asthma pathogenesis. This study highlights a potential strategy for the primary prevention of childhood asthma, namely improved recognition and management of mental health issues and stress in pregnant mothers.
我们旨在确定孕期孕产妇心理健康服务的使用情况（一种潜在的产前孕产妇压力替代指标）是否与大量基于人群的儿童样本中哮喘的发生有关。我们假设孕期使用心理健康服务的母亲所生的孩子患儿童哮喘的发病率更高。
利用加拿大安大略省的卫生行政数据（人口超过1300万）来识别在2001年4月1日至2002年3月31日期间生育子女的母亲与子女的配对情况。使用描述性统计来比较母亲在孕期是否使用心理健康服务的儿童在12岁时哮喘的累积发病率。在对儿童的性别、居住情况（农村与城市）、社会经济地位、合并健康状况、低出生体重和母亲哮喘病史进行调整后，使用多变量逻辑回归来估计产前孕产妇心理健康服务使用与儿童哮喘发病率之间的关联。
在一个基于人群的122333名儿童样本中，孕期使用心理健康服务的母亲所生的孩子患哮喘的几率增加（优势比：1.16，95%置信区间：1.12，1.20，p<0.001）。
产前孕产妇心理健康服务的使用是儿童哮喘发生的一个独立危险因素。这支持了越来越多的证据表明子宫内暴露于孕产妇压力因素在哮喘发病机制中的重要性。本研究强调了儿童哮喘一级预防的一种潜在策略，即改善对孕妇心理健康问题和压力的识别与管理。
