Asthma and lower airway disease
Maternal interpersonal trauma and cord blood IgE levels in an inner-city cohort: A life-course perspective

https://doi.org/10.1016/j.jaci.2009.07.030Get rights and content

Background

Prenatal stress affects immunocompetence in offspring, although the underlying mechanisms are not well understood.

Objective

We sought to examine associations between maternal lifetime interpersonal trauma (IPT) and cord blood total IgE levels in a sample of urban newborns (n = 478).

Methods

Maternal IPT during childhood and adolescence (birth to 17 years), adulthood (18 years to index pregnancy), and the index pregnancy were ascertained by using the Revised Conflict Tactics Scale at 28.4 ± 7.9 weeks' gestation. Cord blood IgE levels were derived by using a fluoroenzyme immunoassay. We examined effects of maternal IPT on increased cord blood IgE levels (upper quartile, 1.08 IU/mL) by using logistic regression, adjusting for confounders and mediating variables.

Results

Maternal trauma was categorized as unexposed (n = 285 [60%]), early (childhood and/or teenage years only, n = 107 [22%]), late (adulthood and/or index pregnancy only, n = 29 [6%]), and chronic (early and late, n = 57 [12%]) exposure. Relative to no IPT, early (odds ratio [OR], 1.78; 95% CI, 1.05-3.00) and chronic maternal IPT (OR, 2.25; 95% CI, 1.19-4.24) were independently associated with increased IgE levels in unadjusted analyses. When adjusting for standard controls, including maternal age and race, season of birth, child's sex, and childhood and current socioeconomic status, early effects became nonsignificant (OR, 1.48; 95% CI, 0.85-2.58). Chronic exposure remained significant in fully adjusted models, including standard controls, current negative life events, allergen exposure, and potential pathway variables (maternal atopy, prenatal smoking, and birth weight; OR, 2.18; 95% CI, 1.06-4.50).

Conclusion

These data link chronic trauma over the mother's life course with increased IgE levels in infants at birth. Research examining associations between maternal trauma and indicators of offspring's atopic risk might be particularly relevant in inner-city high-risk populations.

Section snippets

Participants

Participants were from the Asthma Coalition on Community, Environment, and Social Stress project, a prospective cohort originally funded to recruit 500 pregnant women and their children to study the effects of prenatal maternal and early-life stress on urban childhood asthma risk, as described elsewhere.17 Briefly, English- or Spanish-speaking pregnant women who were at least 18 years old and receiving prenatal care at Brigham & Women's Hospital, Boston Medical Center, 3 metropolitan Boston

Results

Table I, Table II describe sample characteristics stratified by periods of IPT over the mother's life course and by IgE categories, respectively. Overall maternal age was 26.6 ± 5.7 years. The sample was largely Hispanic (59%) or black (30%, Table I). More respondents experienced no IPT than early (60% vs 22%, P < .001), late (60% vs 6%, P < .001), or chronic (60% vs 12%, P < 0.001) IPT. More Hispanics relative to blacks or other/mixed race subjects reported no IPT (66% vs 52% [P < .003] and

Discussion

These analyses provide the first suggestion that chronic exposure to IPT across the mother's life course is associated with increased IgE levels in newborns when adjusted for race/ethnicity, childhood and current SES, other current NLEs, household allergens, season of birth, and potential mediators (eg, prenatal smoking, birth weight for gestational age, maternal atopy and IgE level). Although results are most consistent with cumulative life-course effects in the mother potentiating the child's

References (49)

  • Y.Y. Chida et al.

    A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis

    Psychosom Med

    (2008)
  • R.J. Wright

    Prenatal maternal stress and early caregiving experiences: implications for childhood asthma risk

    Paediatr Perinatol Epidemiol

    (2007)
  • F.D. Martinez et al.

    Asthma and wheezing in the first six years of life

    N Engl J Med

    (1995)
  • J.D. Ford et al.

    Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women

    J Interpers Violence

    (2006)
  • R. Yehuda et al.

    Transgenerational transmission of cortisol and PTSD risk

    Prog Brain Res

    (2008)
  • R.J. Wright et al.

    Maternal stress and perinatal programming in the expression of atopy

    Exp Rev Clin Immunol

    (2008)
  • N. Breslau et al.

    Trauma and posttraumatic stress disorder in the community the 1996 Detroit area survey of trauma

    Arch Gen Psychiatry

    (1998)
  • H. Beydoun et al.

    Physical and mental health outcomes of prenatal maternal stress in human and animal studies: a review of recent evidence

    Paediatr Perinatol Epidemiol

    (2008)
  • C. Power et al.

    Social and biological pathways linking early life and adult disease

    Br Med Bull

    (1997)
  • R.F. Anda et al.

    The enduring effects of abuse and related adverse experiences in childhood

    Eur Arch Psychiatry Clin Neurosci

    (2006)
  • S. Rick et al.

    Neurobiological effects of childhood abuse

    J Psychosoc Nurs Ment Health Serv

    (2007)
  • R.J. Wright et al.

    Transdiscplinary research strategies for understanding socially patterned disease: the ACCESS project as a case study

    Ciencia Saude Coletiva

    (2008)
  • M.A. Straus et al.

    A short form of the Revised Conflict Tactics scales, and typologies for severity and mutuality

    Violence Vict

    (2004)
  • L. Nilsson et al.

    Season of birth as predictor of atopic manifestations

    Arch Dis Child

    (1997)
  • Cited by (51)

    • Inflammation: A Proposed Intermediary Between Maternal Stress and Offspring Neuropsychiatric Risk

      2019, Biological Psychiatry
      Citation Excerpt :

      Individuals with posttraumatic stress disorder have elevated cerebrospinal fluid IL-6 (95), elevated peripheral inflammatory markers (96,97), and impaired immune cell glucocorticoid sensitivity (98). In pregnant women, history of trauma exposure was associated with elevated circulating TNF-α (99) and elevated immunoglobulin E levels in cord blood at delivery (100). Prenatal traumatic stress, such as exposure to war, is associated with deficits in child neurodevelopment and mental health in the epidemiologic literature (101–103).

    • Environmental grass pollen levels in utero and at birth and cord blood IgE: Analysis of three birth cohorts

      2018, Environment International
      Citation Excerpt :

      We used 0.5 kU/L as the limit for the lowest group because this was a frequent cut-off level in previous studies to detect IgE in newborns (Kaan et al., 2000; Kerkhof et al., 2005; Kuiper et al., 2006; Sadeghnejad et al., 2007) and it was also the highest detection limit among all cohorts in this study. We used 1.0 kU/L as the limit for highest group as it was the highest IgE level used in previous studies to detect IgE in newborns (Kimpen et al., 1987; Sternthal et al., 2009). We also dichotomized IgE levels into low (<0.5 kU/L) and high (≥0.5 kU/L) to be used for the meta-analysis.

    View all citing articles on Scopus

    The Asthma Coalition on Community, Environment, and Social Stress study was funded by grants R01ES10932, U01HL072494, and R01HL080674. M. S. is supported by grant T32-ES07069-29 and the Leaves of Grass Foundation.

    Disclosure of potential conflict of interest: M. J. Sternthal and R. J. Wright have received research support from the National Institutes of Health and the Leaves of Grass Foundation. M. B. Enlow has received research support from the National Institute of Mental Health and the Children's Brain Research Foundation. S. Cohen has received research support from the National Institutes of Health and the MacArthur Foundation and consulted for Johnson & Johnson Consumer and Personal Products Worldwide. The rest of the authors have declared that they have no conflict of interest.

    View full text