Relationship between maternal demoralization, wheeze, and immunoglobulin E among inner-city children

Volume 107, Issue 1, Pages 42-49.e1 (July 2011)
Relationship between maternal demoralization, wheeze, and immunoglobulin E among inner-city children

Marilyn Reyes, BA†, Matthew S. Perzanowski, PhD†, Robin M. Whyatt, DrPH†, Elizabeth A. Kelvin, PhD, MPH‡, Andrew G. Rundle, DrPH§, Diurka M. Diaz, MA†, Lori Hoepner, MPH†, Frederica P. Perera, DrPH†, Virginia Rauh, ScD∥, Rachel L. Miller, MD†¶#Corresponding Author

Received 3 January 2011; received in revised form 24 February 2011; accepted 4 March 2011. published online 15 April 2011.

Background

Prior research has linked maternal prenatal and postnatal mental health with the subsequent development of asthma in children. However, this relationship has not been examined in inner-city African Americans and Hispanics, populations at high risk for asthma.

Objective

To determine the relationship of maternal demoralization with wheeze, specific wheeze phenotypes, and seroatopy among children living in a low-income, urban community.

Methods

African American and Dominican women aged 18 to 35 years residing in New York City (the Bronx and Northern Manhattan) were recruited during pregnancy (n = 279). Maternal demoralization (ie, psychological distress) was measured both prenatally and postnatally by validated questionnaire. Outcomes included wheeze, transient (birth to 2.5 years of age), late onset (3–5 years), and persistent (birth to 5 years of age), evaluated via questionnaire and total and indoor allergen specific IgE (at birth and ages 2, 3, and 5 years). Logistic regression with generalized estimating equations assessed the association of demoralization with wheeze and atopy. Multinomial regression explored associations between demoralization and specific wheeze phenotypes.

Results

Prenatal demoralization significantly predicted overall wheeze (adjusted odds ratio OR, 1.66; 95% confidence interval [CI], 1.29–2.14), transient wheeze (OR, 2.25; 95% CI, 1.34–3.76), and persistent wheeze (OR, 2.69; 95% CI, 1.52–4.77). No association was found between demoralization and IgE after adjustment (total IgE: OR, 1.04; 95% CI, 0.74–1.45; any specific IgE: OR, 0.96; 95% CI, 0.57–1.60).

Conclusions

In this inner-city cohort, prenatal demoralization was associated with transient and persistent wheeze. Understanding how maternal demoralization influences children's respiratory health may be important for developing effective interventions among disadvantaged populations.

Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York

† Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York

‡ City University of New York (CUNY), School of Public Health at Hunter College, New York, New York

§ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York

∥ Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York

¶ Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York

# Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York

Corresponding Author Information
Requests for reprints should be addressed to: Rachel L. Miller, MD, Columbia University College of Physicians and Surgeons, PH8E, 630 W 168 St New York, NY 10032

Funding Sources: This study was supported by National Institute of Environmental Health Sciences grants 5P50ES015905, R01ES013163, 5P01ES09600, 5R01ES08977, ES013543, and ES01493901; US Environmental Protection Agency grant RD8321; the Educational Foundation of America; the New York Community Trust; the John & Wendy Neu Family Foundation; and the Trustees of the Blanchette Hooker Rockefeller Fund.

Disclosures: Authors have nothing to disclose.
Relationship between maternal demoralization, wheeze, and immunoglobulin E among inner-city children: "- Enviado mediante la barra Google"




Actualidad Ultimas noticias - JANOes - La ansiedad y la depresion en el embarazo pueden aumentar el riesgo de asma del nino - JANO.es - ELSEVIER: "GINECOLOGÍA
La ansiedad y la depresión en el embarazo pueden aumentar el riesgo de asma del niño

JANO.es · 13 Julio 2011 00:00


Un estudio corrobora que el 70% de las madres que dijeron que habían experimentado altos niveles de ansiedad o depresión mientras estaban embarazadas manifestaron que sus hijos tenían respiración sibilante.

Los hijos de mujeres que experimentan ansiedad y depresión en el embarazo podrían presentar un mayor riesgo de contraer asma, según una investigación recient, que aparece publicada en la revista Annals of Allergy, Asthma & Immunology. El estudio de 279 mujeres negras y latinas de zonas marginadas añade peso a investigaciones llevadas a cabo anteriormente con familias caucásicas, que encontraron que los niños son particularmente susceptibles a los riesgos relacionados con el asma en el período prenatal.

'Aproximadamente el 70% de las madres que dijeron que habían experimentado altos niveles de ansiedad o depresión mientras estaban embarazadas manifestaron que sus hijos tenían respiración sibilante antes de los cinco años', apuntó la coautora del estudio, Marilyn Reyes, investigadora del Columbia Center for Children's Environmental Health (Estados Unidos). 'Comprender cómo la depresión materna afecta a la salud respiratoria del niño es importante para desarrollar intervenciones eficaces', añadió Reyes.

El equipo de investigación señaló que entre los síntomas comunes de asma se encuentran la tos nocturna, la respiración sibilante, la dificultad para respirar y los resfriados frecuentes. Los autores del estudio señalaron que los niños que experimenten cualquiera de estos síntomas de forma regular debería consultar a un alergólogo.

'Los síntomas del asma pediátrico van desde una tos molesta que dura días o semanas a emergencias respiratorias repentinas', comentó la Dra. Rachel Miller, coautora del estudio y alergóloga. 'Con el tratamiento adecuado, el niño podrá dormir de noche, evitar faltar a la guardería o la escuela por mucho tiempo, y respirar con facilidad'.


Annals of Allergy, Asthma & Immunology 2011;107:42-49.e1
Relationship between maternal demoralization, wheeze, and immunoglobulin E among inner-city children: "- Enviado mediante la barra Google"

- Enviado mediante la barra Google"