The association between stressful life events and respiratory infections during the first 4 years of life: The Environmental Determinants of Diabetes in the Young study

Stress Health. 2019 Aug;35(3):289-303. doi: 10.1002/smi.2861. Epub 2019 Apr 4.


The aim of this study was to conduct a prospective analysis of the association between negative life events (NLEs) and respiratory infections in children genetically at risk for islet autoimmunity (IA) and type 1 diabetes (T1D). Long- and short-term temporal associations between NLEs and rate of respiratory infection episodes (RIEs) in 5,618 children in The Environmental Determinants of Diabetes in the Young study for at least 1 up to 4 years were analysed. All models were adjusted for demographic, day care, season of infection, and psychosocial factors associated with the rate of child RIEs between study visits. The rate of child RIEs was 26% higher in Europe (Sweden, Finland, Germany) than in the United States (rate ratio [RR] = 1.26, p < 0.001). However, the percentage of child NLEs (odds ratio [OR] = 1.18, p < 0.001) and mother NLEs (OR = 1.83, p < 0.001) was higher in the United States compared with Europe. In both continents (Europe, RR = 1.12, p < 0.001; United States, RR = 1.07, p = 0.006), high child cumulative NLEs (>1 NLE per year since study inception) was significantly associated with an increased rate of child RIEs. This large-scale prospective study confirms observations that stress may increase the susceptibility for infections in paediatric populations and suggests at least one mechanism by which stress could increase risk for IA and T1D in genetically at risk children.

Keywords: autoimmunity; longitudinal study; negative life events; respiratory childhood infections; stress; type 1 diabetes.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Adverse Childhood Experiences*
  • Autoimmunity
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / etiology
  • Diabetes Mellitus, Type 1 / immunology
  • Europe / epidemiology
  • Female
  • Humans
  • Infant
  • Islets of Langerhans / immunology
  • Longitudinal Studies
  • Male
  • Mothers
  • Multivariate Analysis
  • Prospective Studies
  • Regression Analysis
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / immunology
  • Risk Factors
  • Stress, Psychological / epidemiology*
  • United States / epidemiology
  • Young Adult

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