The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, The Netherlands.
Thorax. 2020 Dec;75(12):1074-1081. doi: 10.1136/thoraxjnl-2019-214099. Epub 2020 Oct 12.
Although maternal psychological distress during pregnancy is associated with increased risks of respiratory morbidity in preschool children, it is unknown whether this association persists into later childhood.
To examine the association between parental psychological distress during pregnancy and lung function and asthma in children of school age.
This study of 4231 children was embedded in a population-based prospective cohort. Parental psychological distress was assessed by the Brief Symptom Inventory during and 3 years after pregnancy, and in mothers also at 2 and 6 months after pregnancy. At age 10 years, lung function was obtained by spirometry and asthma by questionnaire.
The prevalence of asthma was 5.9%. Maternal overall psychological distress during pregnancy was associated with a lower forced vital capacity (FVC) (z-score difference -0.10 (95% CI -0.20 to -0.01) per 1-unit increase), maternal depressive symptoms during pregnancy with a lower forced expiratory volume in the first second (FEV) and FVC (-0.13 (95% CI -0.24 to -0.01) and -0.13 (95% CI -0.24 to -0.02) when using clinical cut-offs) in their children. All maternal psychological distress measures during pregnancy were associated with an increased risk of asthma (range OR: 1.46 (95% CI 1.12 to 1.90) to 1.91 (95% CI 1.26 to 2.91)). Additional adjustment for paternal psychological distress during pregnancy and parental psychological distress after pregnancy did not materially change the associations. Paternal psychological distress during pregnancy was not associated with childhood respiratory morbidity.
Maternal, but not paternal, psychological distress during pregnancy is associated with an increased risk of asthma and partly lower lung function in children. This suggests intrauterine programming for the risk of later-life respiratory disease.
尽管孕妇心理困扰与学龄前儿童呼吸道发病率增加有关，但目前尚不清楚这种关联是否会持续到儿童后期。
研究孕妇在怀孕期间的父母心理困扰与学龄儿童的肺功能和哮喘之间的关系。
这项对 4231 名儿童的研究是嵌入在一项基于人群的前瞻性队列研究中进行的。在怀孕期间和怀孕后 3 年，以及在母亲怀孕后 2 个月和 6 个月，通过简明症状量表评估父母的心理困扰。在 10 岁时，通过肺活量计测量肺功能，通过问卷调查测量哮喘。
哮喘的患病率为 5.9%。母亲在怀孕期间的整体心理困扰与用力肺活量（FVC）降低（每增加 1 个单位，z 分数差异为-0.10（95%置信区间-0.20 至-0.01））相关，母亲在怀孕期间的抑郁症状与第一秒用力呼气量（FEV）和 FVC 降低相关（使用临床临界值时，分别为-0.13（95%置信区间-0.24 至-0.01）和-0.13（95%置信区间-0.24 至-0.02））。怀孕期间所有母亲的心理困扰指标都与哮喘的风险增加相关（范围比值比：1.46（95%置信区间 1.12 至 1.90）至 1.91（95%置信区间 1.26 至 2.91））。进一步调整怀孕期间父亲的心理困扰和产后父母的心理困扰并没有实质性地改变这些关联。怀孕期间父亲的心理困扰与儿童呼吸道发病率无关。
孕妇的心理困扰，而不是父亲的心理困扰，与儿童哮喘风险增加和部分肺功能降低有关。这表明宫内编程与晚年呼吸道疾病的风险有关。
