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Parental psychological distress during pregnancy and the risk of childhood lower lung function and asthma: a population-based prospective cohort study
  1. Evelien R van Meel1,2,
  2. Gautam Saharan1,2,
  3. Vincent WV Jaddoe1,3,
  4. Johan C de Jongste2,
  5. Irwin KM Reiss4,
  6. Henning Tiemeier5,6,7,
  7. Hanan El Marroun3,5,8,
  8. Liesbeth Duijts2,4
  1. 1The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
  2. 2Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
  3. 3Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
  4. 4Department of Pediatrics, Division of Neonatology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
  5. 5Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
  6. 6Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
  7. 7Department of Social and Behavioural Science, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  8. 8Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Dr Liesbeth Duijts, Epidemiology, Erasmus Medical Center, Rotterdam 3000, The Netherlands; l.duijts{at}erasmusmc.nl

Abstract

Background 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.

Objective To examine the association between parental psychological distress during pregnancy and lung function and asthma in children of school age.

Methods 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.

Results 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 (FEV1) 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.

Conclusion 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.

  • asthma epidemiology
  • psychology
  • paediatric asthma
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Footnotes

  • ERvM and GS contributed equally.

  • Contributors ERvM, GS and LD contributed to the conception and design, acquisition of data, analyses and interpretation of the data, drafted the article, revised it critically for important intellectual content and gave final approval of the version to be published. VJ, JCdJ, IR, HT and HEM contributed to the conception and design, acquisition of data, revised the drafted manuscript critically for important intellectual content and gave final approval of the version to be published.

  • Funding The Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development. LD received funding from the co-funded programme ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL) (ALPHABET project, Horizon 2020 (grant agreement no 696295; 2017), ZonMW, The Netherlands (no 529051014; 2017)). HT was supported by a grant from the Netherlands Organization for Scientific Research (NWO 016.VICI.170.200). The project received funding from the European Union’s Horizon 2020 research and innovation programme (LifeCycle project, grant agreement no 733209; 2016). The researchers are independent from the funders. The study sponsors had no role in the study design, data analysis, interpretation of data or writing of this report.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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