Maternal stress and depression are associated with respiratory phenotypes in urban children

Background: Prenatal and early-life exposure to maternal stress and depression is linked to development of recurrent wheezing in young children. Objective: We sought to determine whether maternal stress and depression in early life are associated with nonatopic wheezing phenotype in urban children. Methods: The Urban Environment and Childhood Asthma Study examined a birth cohort of children at high risk for asthma in low-income neighborhoods. Prenatal and postnatal (through age 3 years) maternal stress and depression scores were compared with respiratory phenotypes through age 10 years (multinomial regression), self-reported colds (linear regression), and detection of respiratory viruses (Poisson regression). Results: Scores for maternal depression, and, to a lesser extent, maternal perceived stress, were positively related to multiple wheezing phenotypes. In particular, cumulative measures of maternal depression in the first 3 years were related to the moderate-wheeze-low-atopy phenotype (odds ratio, 1.13; [1.05, 1.21]; P < .01). Considering indicators of respiratory health that were used to identify the phenotypes, there were multiple positive associations between early-life scores for maternal stress and depression and increased wheezing illnesses, but no consistent relationships with lung function and some inverse relationships with allergic sensitization. Cumulative maternal stress and depression scores were associated with cumulative number of respiratory illnesses through age 3 years. Conclusions: Among high-risk, urban children, maternal stress and depression in early life were positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype. These results suggest that treating stress and depression in expectant and new mothers could reduce viral respiratory illnesses and recurrent wheeze during the preschool years and some forms of childhood asthma. (J Allergy Clin Immunol 2021;148:120-7.)

Automated summary

Maternal stress and depression in early life are positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype in urban children, indicating the importance of addressing these factors to reduce viral respiratory illnesses and recurrent wheeze during early childhood.