Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study
Open accessAbstract
Background: Previous research has found that maternal stress during pregnancy increases the risk of offspring asthma. However, whether this association is consistent with a causal interpretation has never been tested. The objective is to determine whether there is a critical exposure period for maternal depression or anxiety on offspring asthma or whether cumulative exposure is most important, and to investigate evidence of confounding. Methods: The study population included all children born in Sweden from July 2006 to December 2009 (n = 360 526). Information about childhood asthma, maternal depression or anxiety (diagnosis or medication) and covariates was obtained from the Swedish national health registers. The associations between exposure periods (pre-conception, pregnancy, postnatal or current) and childhood asthma were estimated using structured life course approach hypothesis testing. Paternal and cousin analyses were used to test for evidence of confounding from shared genes and environment. Results: For childhood asthma, cumulative exposure best described the effect of exposure to maternal depression or anxiety up to a maximum of any two exposure periods [adjusted odds ratio 1.44, 95% confidence interval (CI) 1.38, 1.52]. The hypotheses of a critical period were not supported. The paternal and cousin analyses indicated minimal influence from familial confounding. Conclusions: These findings support an association between cumulative exposure to maternal depression or anxiety and asthma development in offspring. This association is unique for maternal depression or anxiety and not due to familial confounding. The clinical implication is that effective psychological management of women with chronic distress may reduce offspring asthma risk.
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There is an established association between asthma and anxiety, and this association is linked to poor health outcomes.
“There is an established relationship between anxiety and asthma, which is associated with poor health outcomes.”
From Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online (2021) · cites this paper as Brew et al., 2018
The Discussion (page not provided) reports an association between chronic maternal depression or anxiety and asthma in offspring. That supports a specific anxiety–asthma association, but not a general relationship between anxiety and asthma or a separate link between that relationship and poor health outcomes. (LLM, conf=0.85)
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Anxiety disorders and asthma among adolescents in Uganda: role of early-life exposures
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Maternal Stress and Allergic Diseases in Children: A systematic review
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- Authors
- Brew, B. K., Lundholm, C., Viktorin, A., Lichtenstein, P., Larsson, H., & Almqvist, C.
- Affiliations
- Karolinska Institutet (SE)
- Örebro University (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Brew, Bronwyn K
- ORCID
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-09-23
- Volume
- 47
- Issue
- 1
- Pages
- 166-174
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- PMC
- PMC5837783
- OpenAlex
- W2757516466
- Cited by
- 70
- References
- 38
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 10 · 2019: 6 · 2018: 5
- FWCI
- 4.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Epidemiology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Swedish Research Council
- Stockholm County Council
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- childhood asthma, maternal depression, maternal anxiety, maternal mental health, cumulative exposure, pregnancy, postpartum period, familial confounding
- MeSH terms
- Adult, Anxiety, Asthma, Child, Preschool, Depression, Female, Humans, Infant, Longitudinal Studies, Male, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Risk Factors, Sweden, Logistic Models
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