Longitudinal assessment of maternal depression and later life childhood
asthma and wheeze: effect modification by child sex
Background: Studies report associations between maternal mental
health and adverse respiratory outcomes in children; however, the impact
of timing and duration of maternal distress remains understudied. We
sought to longitudinally examine associations between maternal
depression and childhood asthma and wheeze, and explore sex differences.
Methods: Maternal depression (n=605) were assessed using the
Edinburgh Depression Scale questionnaire, dichotomized at a clinically
relevant cutoff (>12) a) during pregnancy, b) postpartum,
and c) postpartum and subsequent time points postnatally (recurrent
depression). Report of wheeze in the past 12 months (current wheeze) and
asthma were obtained using a validated survey at 48 and 72 months.
Associations were analyzed using a modified Poisson regression adjusted
for covariates, and in interaction models. Results: Both
postpartum and recurrent depression were associated with higher risk of
current wheeze (RR: 1.88, 95% CI: 1.21, 2.92; RR: 2.39, 95% CI: 1.52,
3.78) and asthma at 48 months (RR: 2.79, 95% CI: 1.13, 6.87; RR: 3.14,
95% CI: 1.26, 7.84). In interaction analyses, associations were
stronger in females. Postpartum and recurrent depression were associated
with higher risk of current wheeze at 48 months in females (RR: 3.06,
95% CI: 1.48, 6.32; RR: 4.02, 95% CI: 1.91, 8.46) when compared to
males RR: 1.47, 95% CI: 0.84, 2.56; RR: 1.86, 95% CI: 1.04, 3.34).
Conclusions: Postpartum and recurrent depression were
associated with higher risk of wheeze and asthma in children, and
associations were stronger in females than males. Understanding the
temporal- and sex-specific effects of maternal depression may better
inform prevention strategies.