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母亲的压力和抑郁与城市儿童的呼吸表型有关。

Maternal stress and depression are associated with respiratory phenotypes in urban children.

机构信息

Department of Pediatrics, University of Wisconsin - Madison, Madison, Wis.

Rho Federal Systems Division, Inc, Chapel Hill, NC.

出版信息

J Allergy Clin Immunol. 2021 Jul;148(1):120-127. doi: 10.1016/j.jaci.2021.03.005. Epub 2021 Mar 10.

Abstract

BACKGROUND

Prenatal and early-life exposure to maternal stress and depression is linked to development of recurrent wheezing in young children.

OBJECTIVE

We sought to determine whether maternal stress and depression in early life are associated with nonatopic wheezing phenotype in urban children.

METHODS

The Urban Environment and Childhood Asthma Study examined a birth cohort of children at high risk for asthma in low-income neighborhoods. Prenatal and postnatal (through age 3 years) maternal stress and depression scores were compared with respiratory phenotypes through age 10 years (multinomial regression), self-reported colds (linear regression), and detection of respiratory viruses (Poisson regression).

RESULTS

Scores for maternal depression, and, to a lesser extent, maternal perceived stress, were positively related to multiple wheezing phenotypes. In particular, cumulative measures of maternal depression in the first 3 years were related to the moderate-wheeze-low-atopy phenotype (odds ratio, 1.13; [1.05, 1.21]; P < .01). Considering indicators of respiratory health that were used to identify the phenotypes, there were multiple positive associations between early-life scores for maternal stress and depression and increased wheezing illnesses, but no consistent relationships with lung function and some inverse relationships with allergic sensitization. Cumulative maternal stress and depression scores were associated with cumulative number of respiratory illnesses through age 3 years.

CONCLUSIONS

Among high-risk, urban children, maternal stress and depression in early life were positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype. These results suggest that treating stress and depression in expectant and new mothers could reduce viral respiratory illnesses and recurrent wheeze during the preschool years and some forms of childhood asthma.

摘要

背景

母亲在孕期和生命早期所经历的压力和抑郁与幼儿反复喘息的发生有关。

目的

我们旨在确定生命早期的母亲压力和抑郁是否与城市儿童的非特应性喘息表型有关。

方法

城市环境与儿童哮喘研究(Urban Environment and Childhood Asthma Study)调查了处于低社会经济地位街区的、具有哮喘高风险的儿童出生队列。通过多分类回归比较了产前和产后(至 3 岁)的母亲压力和抑郁评分与呼吸表型(至 10 岁)、自我报告的感冒(线性回归)和呼吸道病毒检测(泊松回归)之间的关系。

结果

母亲抑郁评分,以及在较小程度上的母亲感知压力评分,与多种喘息表型呈正相关。特别是,前 3 年母亲抑郁的累积评分与中-轻喘-低特应性表型相关(比值比,1.13;[1.05,1.21];P<.01)。考虑到用于确定表型的呼吸健康指标,生命早期母亲压力和抑郁评分与更多的喘息疾病呈正相关,但与肺功能无一致关系,与一些过敏敏感呈负相关。累积的母亲压力和抑郁评分与 3 岁前的累积呼吸道疾病数量相关。

结论

在高危的城市儿童中,生命早期的母亲压力和抑郁与呼吸道疾病和中-轻喘-低特应性表型呈正相关。这些结果表明,治疗预期和新母亲的压力和抑郁可能会减少幼儿期的病毒性呼吸道疾病和反复喘息,以及某些形式的儿童哮喘。

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