Longitudinal assessment of maternal depression and later life childhood asthma and wheeze: effect modification by child sex

Background: Studies report associations between maternal mental health and adverse respiratory outcomes in children; however, the impact of timing and duration of maternal distress remains understudied. We sought to longitudinally examine associations between maternal depression and childhood asthma and wheeze, and explore sex differences. Methods: : Maternal depression (n=605) were assessed using the Edinburgh Depression Scale questionnaire, dichotomized at a clinically relevant cutoff (>12) a) during pregnancy, b) postpartum, and c) postpartum and subsequent time points postnatally (recurrent depression). Report of wheeze in the past 12 months (current wheeze) and asthma were obtained using a validated survey at 48 and 72 months. Associations were analyzed using a modified Poisson regression adjusted for covariates, and in interaction models. Results: : Both postpartum and recurrent depression were associated with higher risk of current wheeze (RR: 1.88, 95% CI: 1.21, 2.92; RR: 2.39, 95% CI: 1.52, 3.78) and asthma at 48 months (RR: 2.79, 95% CI: 1.13, 6.87; RR: 3.14, 95% CI: 1.26, 7.84). In interaction analyses, associations were stronger in females. Postpartum and recurrent depression were associated with higher risk of current wheeze at 48 months in females (RR: 3.06, 95% CI: 1.48, 6.32; RR: 4.02, 95% CI: 1.91, 8.46) when compared to males RR: 1.47, 95% CI: 0.84, 2.56; RR: 1.86, 95% CI: 1.04, 3.34). Conclusions: : Postpartum and recurrent depression were associated with higher risk of wheeze and asthma in children, and associations were stronger in females than males. Understanding the temporal- and sex-specific effects of maternal depression may better inform prevention strategies.