The effect of prenatal maternal stress on childhood asthma development

Abstract

Introduction: About 235 million people suffer from asthma worldwide and it is the most common chronic disease found among children (World Health Organisation, 2017). Evidence suggests that atopic diseases such as asthma are greatly impacted by genetic predisposition and exposure to certain environments, leading to an altered immune response (Andersson, 2015). A large amount of research has recently been focused on the effects of the in utero environment on health later in life. The impact of maternal stress on the alteration of the hypothalamic-pituitary-adrenal (HPA) axis – which impacts atopic diseases – has been supported by recent research (Cookson, 2009). In this dissertation, the effect of prenatal maternal stress on asthma development will be studied.

Research Question: Does prenatal maternal stress increase the risk of childhood asthma development in their children?

PEO Elements: The population (P) studied was children. The exposure (E) observed was prenatal maternal stress. The outcome (O) studied was asthma development.

Method: The keywords identified in the research question were used to create other search terms. Boolean operators and limiters were applied to the EBSCOhost and PubMed databases in order to identify relevant articles. Inclusion and exclusion criteria were also applied to narrow down the literature to seven articles; one meta-analysis and six cohort studies. CASP tools were used to critically appraise and evaluate the articles.

Results: Overall the studies concluded that prenatal maternal stress leads to an increased risk of children developing asthma. Conclusions about the specific types of stress which increase the risk of developing asthma could not be drawn because different proxies for stress were used in the included studies.

Recommendations Raising awareness about maternal health is important. This can be done through educating the general public, particularly women and expecting parents. Assessment tools for early identification and management interventions were provided. Recommendations for the local setting and future research were also presented.