Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, China; Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan 243011, Anhui, China.
J Affect Disord. 2023 Nov 1;340:312-320. doi: 10.1016/j.jad.2023.08.037. Epub 2023 Aug 6.
The fetal immune system and consequent elevated risk of asthma in childhood may be impacted by maternal anxiety during pregnancy. Limited studies have evaluated whether there was a sensitive period and cumulative effect of the relationship between prenatal anxiety and children's asthma.
3131 mother-child pairs made up the study's sample from the Ma'anshan Birth Cohort Study in China. Maternal anxiety status was repeated three times using the pregnancy-related anxiety questionnaire in the 1st, 2nd and 3rd trimesters of pregnancy. Diagnostic information on asthma was collected three times at 24, 36, and 48 months of age.
After adjusting for confounders, children born to mothers with anxiety in the 1st, 2nd and 3rd trimesters of pregnancy all had an elevated risk of total asthma from 12 to 48 months of age. After further adjusting prenatal anxiety in the other trimesters, no association was observed between prenatal anxiety in any trimester and preschoolers' asthma. Children of mothers with persistently high anxiety score trajectory during pregnancy had an elevated risk of total asthma and high prevalence trajectory of asthma. Cumulative effects analysis showed that the more frequent the mother's anxiety, the higher the risk of her offspring developing a high prevalence trajectory of asthma from 12 to 48 months of age. The results of the subgroup analysis by age showed similar associations overall.
Maternal antenatal anxiety was associated with an elevated risk of preschool children's asthma, and a possible cumulative effect was observed. Maternal mental health conditions during pregnancy should receive constant attention throughout pregnancy, not just during one period.
胎儿的免疫系统以及随之而来的儿童时期哮喘风险增加可能会受到母亲怀孕期间焦虑的影响。有限的研究评估了产前焦虑与儿童哮喘之间的关系是否存在敏感时期和累积效应。
本研究的样本由来自中国马鞍山出生队列研究的 3131 对母婴组成。使用妊娠相关焦虑问卷在妊娠第 1、2 和 3 个 trimester 重复三次评估母亲的焦虑状态。在 24、36 和 48 个月大时,三次收集关于哮喘的诊断信息。
在调整了混杂因素后,在妊娠第 1、2 和 3 个 trimester 时患有焦虑症的母亲所生的孩子在 12 至 48 个月时患总哮喘的风险均升高。进一步调整其他 trimester 的产前焦虑后,任何 trimester 的产前焦虑与学龄前儿童哮喘之间均无关联。在怀孕期间持续存在高焦虑评分轨迹的母亲的孩子患总哮喘和高流行率哮喘的风险增加。累积效应分析表明,母亲焦虑的频率越高,其子女在 12 至 48 个月期间患高流行率哮喘的风险越高。按年龄进行的亚组分析结果总体上显示出类似的关联。
母亲产前焦虑与学龄前儿童哮喘风险增加有关,且观察到可能存在累积效应。怀孕期间应持续关注母亲的心理健康状况,而不仅仅是在某一时期。