Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.
The Department of Pediatrics and Adolescent Medicine, University of Turku, and Turku University Hospital, Turku, Finland.
Pediatr Allergy Immunol. 2022 Jan;33(1):e13706. doi: 10.1111/pai.13706. Epub 2021 Dec 5.
Exposure to prenatal maternal psychological distress may contribute to the development of childhood atopic disorders. Little is known about the importance of distress severity and its duration for the risk. Our aim was to investigate how chronic maternal depressive and anxiety symptoms across gestation influence the risk of wheezing and eczema at child age 24 months.
The study population was drawn from the FinnBrain Birth Cohort Study, including 1305 mother-infant dyads followed across gestation until the child age of 24 months when the outcomes were mother-reported wheezing ever and doctor-diagnosed eczema. To investigate the risk of wheezing phenotypes, wheezing with and without eczema was separated. Maternal distress was assessed with the Edinburgh Postnatal Depression Scale for depressive and the Symptom Checklist-90 for anxiety symptoms three times during pregnancy, and the chronicity was demonstrated using symptom trajectories composed by latent growth mixture modeling.
Of the children, 219/1305 (17%) had wheezing ever and 285/1276 (22%) had eczema. Risk of wheezing ever was elevated with maternal consistently high depressive symptoms (adjusted odds ratio 2.74; 95% confidence interval 1.37-5.50) or moderate and increasing anxiety symptoms (1.94; 1.06-3.54, respectively). Similarly, wheezing without eczema was associated with consistently high depressive (3.60; 1.63-7.94, respectively) and moderate and increasing anxiety symptoms (2.43; 1.21-4.91, respectively).
Maternal chronic psychological distress across gestation was associated with toddler wheezing and especially wheezing without other atopic features (eczema). This finding supports the theory of intrauterine programming effect by maternal psychological distress on offspring immune system and respiratory morbidity.
产前母亲心理困扰的暴露可能导致儿童特应性疾病的发生。对于困扰的严重程度及其持续时间对风险的重要性知之甚少。我们的目的是研究妊娠期间慢性母亲抑郁和焦虑症状如何影响 24 个月儿童喘息和湿疹的风险。
该研究人群来自芬兰大脑出生队列研究，包括 1305 对母婴对，在妊娠期间一直随访至 24 个月儿童期，此时母亲报告有喘息史和医生诊断的湿疹。为了研究喘息表型的风险，将有和没有湿疹的喘息分开研究。在妊娠期间三次使用爱丁堡产后抑郁量表评估母亲的抑郁症状和症状清单-90 评估焦虑症状，使用潜在增长混合建模的症状轨迹来证明慢性。
在这些儿童中，17%（219/1305）有喘息史，22%（285/1276）有湿疹。母亲持续高抑郁症状（调整后的优势比 2.74；95%置信区间 1.37-5.50）或中度和增加的焦虑症状（1.94；1.06-3.54）时，喘息的风险增加。同样，没有湿疹的喘息与持续高抑郁（分别为 3.60；1.63-7.94）和中度和增加的焦虑症状（分别为 2.43；1.21-4.91）相关。
妊娠期间慢性母亲心理困扰与幼儿喘息有关，尤其是与无其他特应性特征（湿疹）的喘息有关。这一发现支持了母亲心理困扰对后代免疫系统和呼吸道发病率的宫内编程效应理论。
