Maternal Depressive Symptoms, Lung Function, and Severe Asthma Exacerbations in Puerto Rican Children
Erica L Stevens1, Yueh-Ying Han1, Franziska Rosser1
1Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa.
Insights
Persistent maternal depression symptoms over five years are linked to poorer lung function and more severe asthma attacks in children. This highlights the impact of maternal mental health on pediatric asthma outcomes.
Area of Science:
- Pediatric pulmonology
- Child and adolescent psychiatry
- Public health
Background:
- Maternal depression is a known factor influencing healthcare utilization for childhood asthma.
- Previous studies were cross-sectional or short-term, limiting understanding of long-term effects.
Purpose of the Study:
- To investigate the association between persistent or increasing maternal depressive symptoms over five years and severe asthma exacerbations or impaired lung function in youth.
- To assess the long-term impact of maternal mental health on pediatric asthma severity.
Main Methods:
- Prospective study of 386 Puerto Rican youth (ages 6-14 at baseline, 9-20 at follow-up).
- Maternal depressive symptoms assessed using the Center for Epidemiologic Studies Depression Scale (CESD) at two time points approximately five years apart.
- Outcomes included changes in lung function (percent predicted forced expiratory volume in 1 second [FEV1] and FEV1/forced vital capacity [FVC]) and severe asthma exacerbations.
Main Results:
- Each 1-point increase in CESD score correlated with a 0.15% decrease in %pred FEV1 and a 0.10% decrease in %pred FEV1/FVC.
- Maternal depressive symptoms at one or both visits were associated with a 3.17 to 3.52 times increased odds of severe asthma exacerbations.
- A trend towards increased odds of severe asthma exacerbations was observed with each CESD point increment (OR 1.03).
Conclusions:
- Sustained or worsening maternal depressive symptoms over five years are significantly associated with reduced lung function and increased severe asthma exacerbations in Puerto Rican youth.
- Findings underscore the importance of addressing maternal mental health in managing pediatric asthma, particularly in high-risk populations.
Background:
Maternal depression has been linked to health care use for asthma in cross-sectional or short-term follow-up studies of school-aged children.
Objective:
To examine whether increased or persistent maternal depressive symptoms over approximately 5 years are associated with severe asthma exacerbations or worse lung function in youth.
Methods:
A prospective study of 386 youth living in Puerto Rico, aged 6 to 14 years at a baseline visit and 9 to 20 years at a second visit, was performed. Our exposure of interest was change in persistence of maternal depressive symptoms, assessed at both visits using the Center for Epidemiologic Studies Depression Scale (CESD). Our outcomes of interest were change in percent predicted forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) between the first and second visits in all subjects, and ≥1 severe asthma exacerbation in the year before the second visit in subjects with asthma.
Results:
In a multivariable analysis, each 1-point increment in the CESD score was associated with decrements of 0.15% in percent predicted FEV1 (95% confidence interval [CI] = -0.28% to -0.01%; P = .03) and 0.10% in percent predicted FEV1/FVC (95% CI = -0.20% to 0.001%; P = .05) between visits, as well as with 1.03 times increased odds of ≥1 severe asthma exacerbation at the second visit (95% CI for odds ratio = 0.99 to 1.06, P = .09). In a multivariable analysis, the presence of maternal depressive symptoms (a CESD score ≥21 points) at the second visit or at both visits was significantly associated with 3.17 to 3.52 times increased odds of ≥1 severe asthma exacerbation in the year before the second visit.
Conclusions:
Increasing or persistent maternal depressive symptoms over approximately 5 years are associated with worse lung function measures and severe asthma exacerbations among Puerto Rican youth, a high-risk population.
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