Maternal Stress and Depression are Associated with Development of a High-Wheeze, Low-Atopy Phenotype in Their Young Offspring

RATIONALE: Environmental exposures in early life may result in a specific respiratory phenotypes later. We sought to determine whether exposure to maternal stress and depression prenatally and in early life influences the development of specific longitudinal phenotypes of childhood wheezing and atopyin a high-risk, urban birth cohort.

METHODS: The Urban Environment and Childhood Asthma (URECA) study examined a birth cohort at high risk for asthma with parental history of allergic disease and/or asthma through age 7 years (n=442). From birth to age 7, we annually assessed maternal stress using the 4-item Perceived Stress Scale and maternal depression using the Edinburgh Postnatal Depression Scale. Respiratory phenotypes describing longitudinal atopy, wheeze, and lung function were identified using a latent class mixture model. Differences among these phenotypes in maternal stress and depression were examined using analysis of variance.

RESULTS: We identified 5 phenotype groups of childhood wheezing and atopy: 1) low wheeze, low atopy (“LW-LA,” n=117); 2) low wheeze, high atopy (“LW-HA,” n=81); 3) transient wheeze, low atopy (“TW-LA,” n=75); 4) high wheeze, low atopy (“HW-LA,” n=101); and 5) high wheeze, high atopy (“HW-HA,” n=68). Significant differences were found across phenotypes in maternal depression and perceived stress for all time points examined, with the highest reported values in the HW-LA group.

CONCLUSIONS: Our results demonstrate that early life exposures in children at high-risk for asthma to maternal stress and depression are specifically associated with the HW-LA respiratory phenotype.