Prenatal adverse life events increase the risk for atopic diseases in children, which is enhanced in the absence of a maternal atopic predisposition

• Published in: Journal of allergy and clinical immunology Vol. 134; no. 1; pp. 160 - 169.e7
• Main Authors: Hartwig, Isabel R.V., Sly, Peter D., Schmidt, Louis A., van Lieshout, Ryan J., Bienenstock, John, Holt, Patrick G., Arck, Petra C.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2014; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Age; Allergic diseases; allergic rhinitis; Allergies; Allergy and Immunology; Asthma; Asthma - etiology; Asthma - immunology; Asthma - pathology; Atopic disease; Australia; Biological and medical sciences; Child; Chronic obstructive pulmonary disease, asthma; Disease; eczema; Eczema - etiology; Eczema - immunology; Eczema - pathology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hospitals; Humans; Immune system; Immunopathology; Logistic Models; Longitudinal Studies; Male; Mediation; Medical research; Medical sciences; Mothers; negative life events; Odds Ratio; Pneumology; Pregnancy; Prenatal Exposure Delayed Effects - immunology; Prenatal Exposure Delayed Effects - pathology; Prenatal Exposure Delayed Effects - psychology; prenatal programming; Risk; Risk Factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Skin allergic diseases. Stinging insect allergies; Stress; Stress, Psychological - complications; Stress, Psychological - immunology; Stress, Psychological - pathology; Stress, Psychological - psychology; Studies; Surveys and Questionnaires; Australia; OR; prenatal programming; Atopic disease; pregnancy; eczema; asthma; allergic rhinitis; negative life events; child; Odds ratio; Allergy; Skin disease; Nose disease; Rhinitis; Toxicity; Programming; Risk; Atopy; Prenatal; Immunology; Mother; Eczema; Predisposition; Secondary effect; ENT disease; Bronchus disease; Female; Obstructive pulmonary disease; Child; Human; Lung disease; Immunopathology; Respiratory disease; Increase; Asthma; Pregnancy; Life events; Risk factor
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2014.01.033

There is evidence to suggest an association between prenatal maternal stress and the development of asthma or other atopic diseases in offspring. Yet, insights on the lasting effect of multiple, common prenatal stressors are rare, and the effects of prenatal timing are poorly understood. Further, it remains elusive if prenatal life events modify the risk for atopic diseases in the context of a parental predisposition to atopy. We tested whether women's experiences of common, adverse life events during the first or second half of pregnancy predicted the risk of developing atopic diseases in their children and whether a reported parental atopic disease moderated this association. We calculated the odds of a child developing asthma, eczema, and/or allergic rhinitis at ages 6 or 14 years, depending on maternal prenatal exposure to negative life events in a sample of 1587 children from the Western Australian Pregnancy Cohort (Raine) Study by using multivariable logistic regression. We observed that the likelihood of asthma and eczema at age 14 years was significantly increased in children of mothers who had experienced adverse life events during the second half of gestation (1 life event: adjusted odds ratio for asthma, 2.08 [95% CI, 1.22-3.54]). A stronger increase in the odds to develop asthma upon prenatal life events was present in children of mothers without asthma compared with mothers with asthma. Maternal adverse life events during the second half of gestation are linked to an increased risk for the development of atopic disorders, asthma, and eczema, in the case of asthma, particularly in the absence of a maternal asthma.