Associations between postpartum depressive symptoms and childhood asthma diminish with child age

Clin Exp Allergy. 2017 Mar;47(3):324-330. doi: 10.1111/cea.12837. Epub 2016 Nov 28.

Abstract

Background: Affecting 19% of women, postpartum depression is a major concern to the immediate health of mothers and infants. In the long-term, it has been linked to the development of early-onset asthma at school entry, but only if the depression persists beyond the postnatal period. No studies have tested whether associations with postpartum depressive symptoms and early-onset asthma phenotypes persist into later school age.

Objective: To determine associations between maternal postpartum depressive symptoms and childhood asthma between the ages of 5-10 by using a nested longitudinal design.

Methods: Data were drawn from the 1994-2004 administrations of the Canadian National Longitudinal Survey of Children and Youth, which tracks the health of a nationally representative sample of children in Canada. Child asthma was diagnosed by a health professional, and maternal depressive symptoms were assessed by the Centre for Epidemiological Studies Depression scale. Analyses were conducted by using a multilevel modelling approach, in which longitudinal assessments of asthma in 1696 children were nested within the exposure of postpartum depression.

Results: Postpartum depressive symptoms had a 1.5-fold significant association with childhood asthma between the ages 6-8. This was independent of male sex, maternal asthma, non-immigrant status, low household socioeconomic status, being firstborn, low birthweight, low family functioning and urban-rural residence, of which the first 4 covariates elevated the risk of asthma. Statistical significance was lost at age 8 when maternal prenatal smoking replaced urban-rural residence as a covariate. At ages 9-10, an association was no longer evident.

Conclusions and clinical relevance: Women affected by postpartum depressive symptoms are concerned about long-term health effects of their illness on their infants. Although postpartum depressive symptoms were associated with school-age asthma at ages 6 and 7, this association diminished later. Both home and school life stress should be considered in future studies on asthma development later in childhood.

Keywords: asthma; epidemiology; pediatrics.

MeSH terms

  • Age Factors
  • Asthma / epidemiology*
  • Asthma / etiology*
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Depression, Postpartum / complications*
  • Depression, Postpartum / diagnosis
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Population Surveillance
  • Risk
  • Symptom Assessment