Abstract
ObjectiveTo determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children.Study designAnalysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high ‘internalizing’ (anxious/depressive) and ‘externalizing’ (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were ‘none’; ‘early onset transient’ (infancy/preschool only); ‘persistent’ (infancy/preschool and at school age); and ‘late onset’ (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old.ResultsPersistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association.ConclusionsMaternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being.
Highlights
MethodsSubjects were participants in the Avon Longitudinal Study of Parents and Children (ALSPAC)
Children with eczema and asthma have been reported to have poorer mental well-being than healthy children; childhood asthma has been associated with anxiety, depression, emotional and behavioral problems, and treatment for a mental health problem,[1,2,3,4,5,6,7,8,9] and childhood eczema with increased emotional problems and a higher risk of attention deficit/hyperactivity disorder (ADHD).[10,11,12,13,14]
Childhood eczema and asthma are associated with maternal anxiety and depression; mothers who are anxious or depressed during pregnancy, the postpartum period, and beyond are at increased risk of having a child with asthma or wheezing.[15,16,17,18]
Summary
Subjects were participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC recruited pregnant women with expected dates of delivery between April 1, 1991 and December 31, 1992 who lived in a defined geographic area (Avon, United Kingdom). The children have been studied throughout their lives using maternal or self-report questionnaires and, from the age of 7 years, approximately annual research clinic visits. There were 14 062 live births, 13 988 children were alive at 1 year and over 7000 mothers completed the 8-year questionnaire. The study sample in this paper comprises the 7250 singletons with outcome data at 8 years of age.
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