Yean Jung Choi, PhD
,
University of Ulsan College of Medicine, Seoul, South Korea
Si Hyeon Lee, BS
,
Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea
Mi-Jin Kang, MS
,
Asan Institute for Life Science, University of Ulsan College of Medicine, Seoul, South Korea
Eun Lee, MD
,
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Hyun-Ju Cho, MD
,
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Young-Ho Kim, MD
,
Asan Medical Center, Seoul, South Korea
Song-I Yang, MD
,
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, South Korea
Youn Ho Shin, MD
,
Department of Pediatrics, CHA University School of Medicine, Seoul, South Korea
Kangmo Ahn, MD
,
Samsung Medical Center, Seoul, South Korea
Kyung Won Kim, MD, PhD
,
Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, South Korea
Yoon Hee Kim, MD
,
Department of Pediatrics and Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
Dongin Suh, MD
,
Department of Pediatrics, Seoul National University Hospital, Seoul, South Korea
So-Yeon Lee, MD
,
Pediatrics, Hallym University College of Medicine, Anyang, South Korea
Hyoung Yoon Chang, MD
,
Ajou University College of Medicine, Suwon, South Korea
In Ae Choi, PhD
,
Sewon Infant Child Development Center, Seoul, South Korea
Kyung-Sook Lee, PhD
,
Hanshin University, Osan, South Korea
Yee-Jin Shin, MD
,
Yonsei University College of Medicine, Seoul, South Korea
Eun-Jin Kim, PhD
,
Korea National Institute of Health, Cheongju, South Korea
Jeom Gyu Lee, PhD
,
Korea National Institute of Health, Cheongju, South Korea
Min Jee Kim, MD
,
Asan Medical Center, Seoul, South Korea
Jihye You, MD
,
Asan Medical Center, Seoul, South Korea
Soo-Jong Hong, MD, PhD
,
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Background: Recently, we found prenatal maternal depression and anxiety were related to their offspring’s respiratory infection and atopic dermatitis in infancy. Psychological stress should be considered an important programming factor for wheezing and lung development in early life. Moreover, genetic susceptibility influences the effects between offspring’s health and maternal prenatal distress.
Objective: To investigate whether prenatal maternal distress is associated with offspring’s recurrent wheezing (RW) and GSDMB polymorphism influence this relationship in early childhood.
Methods: The study population consisted of 1074 mother baby dyads recruited from COCOA birth cohort study. Prenatal maternal distress was evaluated by self-reported questionnaires at 36th weeks of pregnancy. Center for Epidemiological Studies-Depression-10 (CESD-10) and State-Trait Anxiety Inventory-Trait subscale (STAI-T) were used to measure maternal depression and anxiety, respectively. Genotyping for GSDMB (rs4794820) performed by TaqMan assay. Diagnosis of RW was assessed by parental report of a physician’s diagnosis at 6 months, 1, 2, and 3 year of age and RW was defined as ≥3 reports of wheezing in the first 2 years of life. We also used Cox regression to estimate the association between prenatal maternal distress and offspring’s RW.
Results: The cumulative incidence (CI) of RW was 18.9% by age 2. Prenatal maternal depression (aOR 2.75, 95% CI 1.28-5.93) and anxiety (aOR 2.83, 95% CI 1.09-7.35) increased their offspring’s RW by age 2. The hazard ratio (HR) of having a RW up to 3 years of follow-up was 1.43 (95% CI 1.08-1.90) for depression and 1.63 (95% CI 1.21-2.20) for anxiety. Furthermore, the GA and AA genotypes of GSDMB was associated with a higher risk of RW. With GSDMB GA and AA genotypes, prenatal maternal depression (aOR 8.21, 95% CI 2.51-26.86, p for interaction 0.75) and anxiety (aOR 20.94, 95% CI 2.36-186.40, p for interaction 0.34) increased the risk of offspring’s RW.
Conclusion: Prenatal maternal depression and anxiety increased the risk of RW in early childhood. In addition, prenatal maternal depression and comorbid anxiety was associated with a higher risk of offspring’s RW. The effect of maternal prenatal distress on the development of RW may be modified by GSDMB polymorphism although no significant interaction was found between prenatal distress and GSDMB. Our findings suggest that preventive strategies for reduction of prenatal distress may improve the risk of RW in the offspring.
Funding source: This research was supported by funds (2008-E33030-00, 2009-E33033-00, 2011-E33021-00, 2012-E33012-00, 2013-E51003-00, and 2014-E51004-00) from the Research of Korea Centers for Disease Control and Prevention.
