Abstract
BackgroundPrevious studies indicate that maternal anxiety is associated with asthma in the adolescent child, but mechanisms are unclear.ObjectiveTo investigate the association between maternal anxiety and maternal, self- and register-based report of asthma in the adolescent child, and whether the association remains after control of familial confounding (shared environmental and genetic factors).MethodFrom the Twin and Offspring Study of Sweden, 1691 mothers (1058 twins) and their adolescent child were included. The association between maternal self-reported anxiety (Beck Anxiety Inventory (BAI) and Karolinska Scales of Personality (KSP) somatic or psychic anxiety) and asthma based on subjective (maternal or child report) or objective (register-based diagnosis and medication) measures were analysed using logistic regression. The children-of-twins design was used to explore whether genes or environment contribute to the association.ResultsMaternal BAI anxiety (OR 2.02, CI 1.15–3.55) was significantly associated with adolescent asthma reported by the mother. Maternal KSP somatic anxiety (OR 1.74, CI 1.04–2.91) and psychic anxiety (OR 1.74, CI 1.05–2.86) was significantly associated with breathlessness reported by the adolescent child. In contrast, maternal anxiety was not associated with increased risk for the register-based outcomes of asthma diagnosis or medication. The results remained also after adjusting for covariates and the children-of-twins analyses which indicate that the association was due to familial confounding.ConclusionsWe found some associations between maternal anxiety and subjectively reported offspring asthma or breathlessness which may be due to familial effects. A likely candidate for explaining this familial confounding is heritable personality traits associated with both anxiety and subjective measures of asthma.
Highlights
Asthma is one of the most common chronic diseases in childhood [1]
Maternal Beck Anxiety Inventory (BAI) anxiety was significantly associated with adolescent asthma reported by the mother
Maternal Karolinska Scales of Personality (KSP) somatic anxiety and psychic anxiety was significantly associated with breathlessness reported by the adolescent child
Summary
Asthma is one of the most common chronic diseases in childhood [1]. Several cross-sectional and longitudinal studies indicate that maternal anxiety is associated with asthma; the underlying mechanisms that account for this association are poorly understood [2,3,4,5,6]. Associations between asthma and anxiety may be due to environmental stressors in the family (shared environment), factors that are held in common by the adult parents (non-shared environment) or parent-child associations due to genes that affect anxiety in the parent and asthma in the child. The children-of-twin design offers a possibility of studying whether associations between parental characteristics and child outcomes are causal or due to confounding from genes or familial environment [18]. Mothers reported on their own anxiety and their adolescent children’s asthma symptoms [2,3,6,7,14]. Previous studies indicate that maternal anxiety is associated with asthma in the adolescent child, but mechanisms are unclear. Child Birth weight Preterm birth (,36 weeks) Caesarean section Maternal smoking during pregnancy Birth year, mother. Male Female 1976–1979 1980–1984 1985–1989 1990–1993 Missing Mean (range) ,2500 g $2500 g Missing No Yes Missing No Yes Missing No Yes Missing 1943–1949 1950–1954 1955–1959 1960–1964 1965–1973 Missing No Yes Missing No Yes Missing Compulsory school, 9 yrs Upper secondary school College/university Missing Monozygotic twin Dizygotic twin Partner is twin Missing
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