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, 128 (2), 337-45.e1

Associations Among Maternal Childhood Socioeconomic Status, Cord Blood IgE Levels, and Repeated Wheeze in Urban Children

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Associations Among Maternal Childhood Socioeconomic Status, Cord Blood IgE Levels, and Repeated Wheeze in Urban Children

Michelle J Sternthal et al. J Allergy Clin Immunol.

Abstract

Background: Independent of current socioeconomic status (SES), past maternal SES might influence asthma outcomes in children.

Objective: We examined associations among the mother's SES in the first 10 years of her life (maternal childhood SES), increased cord blood IgE levels (upper 20% [1.37 IU/mL]), and repeated wheeze (≥ 2 episodes by age 2 years) in an urban pregnancy cohort (n = 510).

Methods: Data on sociodemographics, discrimination, financial strain, community violence, interpersonal trauma, and other negative events were obtained prenatally. Prenatal household dust was assayed for cockroach and murine allergens, and traffic-related air pollution was estimated by using spatiotemporal land-use regression. Maternal childhood SES was defined by parental home ownership (birth to 10 years). Maternally reported child wheeze was ascertained at 3-month intervals from birth. Using structural equation models, we examined whether outcomes were dependent on maternal childhood SES directly versus indirect relationships operating through (1) cumulative SES-related adversities, (2) the mother's socioeconomic trajectory (adult SES), and (3) current prenatal environmental exposures.

Results: Mothers were largely Hispanic (60%) or black (28%), 37% had not completed high school, and 56% reported parental home ownership. When associations between low maternal childhood SES and repeated wheeze were examined, there were significant indirect effects operating through adult SES and prenatal cumulative stress (β = 0.28, P = .003) and pollution (β = 0.24, P = .004; P value for total indirect effects ≤ .04 for both pathways). Low maternal childhood SES was directly related to increased cord blood IgE levels (β = 0.21, P = .003). Maternal cumulative adversity (interpersonal trauma) was also associated with increased cord blood IgE levels (β = 0.19, P = .01), although this did not explain maternal childhood SES effects.

Conclusion: Lower maternal childhood SES was associated with increased cord blood IgE levels and repeated wheeze through both direct and indirect effects, providing new insights into the role of social inequalities as determinants of childhood respiratory risk.

Figures

FIG 1
FIG 1
Significant pathways linking low maternal childhood SES to repeated wheeze in offspring. Ovals represent unmeasured latent variables, and boxes represent measured variables. Shaded areas represent prenatal social and physical environmental exposures considered in analyses. All models adjust for maternal atopy/asthma, nativity status, child’s sex, and race. Bolded lines represent significant pathways, and dotted lines represent nonsignificant pathways. Coefficients are listed only for significant pathways. Effect estimates for all tested direct and indirect pathways are provided in the Online Repository (see Table E1). A positive sign indicates that the probability of the categorical dependent variable is increased when the predictor increases. ***P < .001, **P < .01, *P < .05, and +P < .10.
FIG 2
FIG 2
Significant pathways linking low maternal childhood SES to increased cord blood IgE levels. Ovals represent unmeasured latent variables, and boxes represent measured variables. Shaded areas represent prenatal social and physical environmental exposures considered in analyses. All models adjust for maternal asthma/atopy, nativity status, child’s sex, and race. Bolded lines represent significant pathways, and dotted lines represent non-significant pathways. Coefficients are listed only for significant pathways. Effect estimates for all tested direct and indirect pathways are provided in the Online Repository (see Table E1). A positive sign indicates that the probability of the categorical dependent variable is increased when the predictor variable increases. ***P < .001, **P < .01, *P < .05.

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