PURPOSE OF THE STUDY.
To determine if maternal asthma with depression increases the risk for asthma in children compared with maternal asthma without depression.
Two cross-sectional studies of 6- to 14-year-old children in Puerto Rico (PR) (n = 655) and Sweden (SW) (n = 6887).
In the PR cohort, children were randomly selected based on 2009–2010 US census data. A screening questionnaire assessed for self-reported maternal asthma, physician-diagnosed asthma, and wheeze in the child within the preceding year. In the SW cohort, 2005–2010 twin registry data were used to identify children and mothers and provided data on self-reported maternal asthma and physician-diagnosed maternal depression. The validated Center for Epidemiologic Studies Depression Scale was used to assess for maternal depressive symptoms.
Maternal depression was not significantly associated with childhood asthma in the absence of maternal asthma in either cohort. Compared with mothers who had neither asthma nor depressive symptoms, children of mothers who had asthma without depressive symptoms had 3.2 (95% confidence interval [CI] 2.1–4.8) and 2.8 (95% CI 2.1–3.7) times increased odds of asthma in the PR and SW cohorts, respectively. Children of mothers who had both asthma and depressive symptoms had 6.5 (95% CI 3.3–13) and 4.0 (95% CI 1.7–9.6) times increased odds of asthma in the PR and SW cohorts, respectively. There were no statistically significant additive interactions of maternal asthma and depression on childhood asthma development, although there was a trend toward an increased estimated effect of depressive symptoms and depression on childhood asthma.
Maternal depressive symptoms and depression in the presence of maternal asthma increased the risk of childhood asthma development in this cross-cultural study.
This study highlights the importance of managing childhood asthma with a family approach. It is postulated that maternal depression can influence childhood asthma through impaired attention to asthma management with poor health care and medication use. Depression during pregnancy has also been postulated to alter immune responses and the hypothalamic-pituitary adrenal axis, leading to an increased risk of asthma development. Providers should consider probing for maternal or caregiver depression when treating children for asthma.
- Copyright © 2017 by the American Academy of Pediatrics