Asthma and lower airway disease
Parental psychosocial stress and asthma morbidity in Puerto Rican twins

https://doi.org/10.1016/j.jaci.2010.11.010Get rights and content

Background

Little is known about paternal psychosocial factors and childhood asthma.

Objective

We sought to examine the link between maternal and paternal psychosocial stress and asthma outcomes in young children.

Methods

Parents of 339 pairs of Puerto Rican twins were interviewed individually about their own psychosocial stress and about asthma in their children at age 1 year and again about their child's asthma at age 3 years. Fathers were asked about symptoms of posttraumatic stress disorder (PTSD), depression, and antisocial behavior. Mothers were asked about depressive symptoms. Outcomes assessed in children included recent asthma symptoms, oral steroid use and hospitalizations for asthma in the prior year, and asthma diagnosis. Generalized estimated equation models were used for the multivariate analysis of parental psychosocial stress and asthma morbidity in childhood.

Results

After multivariable adjustment, paternal PTSD symptoms, depression, and antisocial behavior were each associated with increased asthma symptoms at age 1 year (eg, odds ratio, 1.08 for each 1-point increase in PTSD score; 95% CI, 1.03-1.14). Maternal depressive symptoms were associated with an increased risk of asthma hospitalizations at age 1 year. At age 3 years, maternal depressive symptoms were associated with asthma diagnosis and hospitalizations for asthma (odds ratio for each 1-point increase in symptoms, 1.16; 95% CI, 1.00-1.36). In an analysis combining 1- and 3-year outcomes, paternal depression was associated with oral steroid use, maternal depressive symptoms were associated with asthma hospitalizations and asthma diagnosis, and parental depression was associated with hospitalizations for asthma.

Conclusions

Both paternal and maternal psychosocial factors can influence asthma morbidity in young Puerto Rican children.

Section snippets

Population

All families with a multiple-gestation pregnancy in Puerto Rico in 2006 were considered for inclusion. Contact information was obtained from the Puerto Rico Neo-natal Twin Registry established with the assistance of the Puerto Rican Department of Health. Of the 481 families with multiple births in 2006, 82 were ineligible because the neonates were triplets or at least 1 twin was deceased. Of the 399 eligible families, 60 chose not to participate, leaving 339 (85%) families each with a set of

Results

Baseline characteristics of the participating children (twins) and their parents are shown in Table I. Of the 339 fathers, 226 (77%) had at least a high school education, and 207 (71%) were working full time; their mean age was 29.8 years (SD, 7 years). Of the 339 mothers, 277 (82%) had at least a high school education, and 118 (35%) were working either full or part time; their mean age was 26.8 years (SD, 6 years). Most (84%) of the 339 parental couples lived together.

Parental asthma, receipt

Discussion

After adjustment for depression in the other parent and other covariates, we found that indicators of paternal psychosocial stress (PTSD symptoms) and psychiatric disorders (major depressive episode and antisocial behavior) were significantly associated with recent asthma symptoms in children at age 1 year but not with any asthma outcome in children at age 3 years. Maternal depressive symptoms were significantly associated with asthma hospitalizations at age 1 year and both asthma

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    Supported by grants HD0496685, HL079966, and HL007427 from the National Institutes of Health.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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