Maternal anxiety during pregnancy and children's asthma in preschool age: The Ma'anshan birth cohort study

Authors：Zhou JX, Guo Y, Teng YZ, Zhu LL, Lu J, Hao XM, Yan SQ, Tao FB, Huang K.

Source：J Affect Disord. 2023 Aug 6;340:312-320.

DOI: 10.1016/j.jad.2023.08.037.

Abstract：

Background: The fetal immune system and consequent elevated risk of asthma in childhood may be impacted by maternal anxiety during pregnancy. Limited studies have evaluated whether there was a sensitive period and cumulative effect of the relationship between prenatal anxiety and children's asthma.

Methods: 3131 mother-child pairs made up the study's sample from the Ma'anshan Birth Cohort Study in China. Maternal anxiety status was repeated three times using the pregnancy-related anxiety questionnaire in the 1st, 2nd and 3rd trimesters of pregnancy. Diagnostic information on asthma was collected three times at 24, 36, and 48 months of age.

Results: After adjusting for confounders, children born to mothers with anxiety in the 1st, 2nd and 3rd trimesters of pregnancy all had an elevated risk of total asthma from 12 to 48 months of age. After further adjusting prenatal anxiety in the other trimesters, no association was observed between prenatal anxiety in any trimester and preschoolers' asthma. Children of mothers with persistently high anxiety score trajectory during pregnancy had an elevated risk of total asthma and high prevalence trajectory of asthma. Cumulative effects analysis showed that the more frequent the mother's anxiety, the higher the risk of her offspring developing a high prevalence trajectory of asthma from 12 to 48 months of age. The results of the subgroup analysis by age showed similar associations overall.

Conclusions: Maternal antenatal anxiety was associated with an elevated risk of preschool children's asthma, and a possible cumulative effect was observed. Maternal mental health conditions during pregnancy should receive constant attention throughout pregnancy, not just during one period.

Keywords: Anxiety; Asthma; Cohort; Pregnancy; Preschool age; Trajectory.

摘要：

背景：胎儿免疫系统和随之而来的儿童哮喘风险升高可能受到孕期母亲焦虑的影响。有限的研究评估了产前焦虑与儿童哮喘之间的关系是否存在一个敏感期和累积效应。

方法：本研究样本来自中国马鞍山出生队列研究的3131对母子。使用妊娠相关焦虑问卷在妊娠1、2、3个月重复3次产妇焦虑状况。在24个月、36个月和48个月时收集了三次哮喘诊断信息。

结果：调整混杂因素后，在妊娠1、2和3个月有焦虑的母亲所生的孩子在12至48个月大时患总哮喘的风险都较高。在进一步调整其他三个月的产前焦虑后，没有观察到任何三个月的产前焦虑与学龄前儿童哮喘之间的关联。妊娠期焦虑评分持续高的母亲，其子女患总哮喘的风险增加，哮喘患病率高。累积效应分析表明，母亲的焦虑越频繁，她的孩子在12至48个月大的时候患哮喘的风险就越高。按年龄划分的亚组分析结果显示，总体上存在相似的关联。

结论：母亲产前焦虑与学龄前儿童哮喘风险升高有关，并观察到可能存在累积效应。孕妇在怀孕期间的心理健康状况应在整个怀孕期间得到持续的关注，而不仅仅是在一个时期。

关键词：焦虑；哮喘；队列；怀孕；学前年龄；轨迹。