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Got Asthma? Blame Mom

Babies with poorly coping moms more susceptible

MONDAY, Oct. 1, 2001 (HealthDayNews) -- Can inadequate parenting cause asthma?

New research to be published this month in Pediatrics links parenting difficulties early in a child's life with an increased risk that the child will develop asthma. In the study, children whose parents had trouble coping had more than double the risk of developing asthma by age 6 to 8.

Other studies have shown that mental factors can worsen existing asthma, a disease in which both environment and genetic makeup are factors. But the new study appears to be the first to link psychological factors with the onset of the disease.

"I don't think anyone has looked at psychological factors from this early in life on," says lead author Mary Klinnert, associate faculty member in the Department of Pediatrics at National Jewish Medical and Research Center and associate professor in the Department of Psychiatry at the University of Colorado Health Sciences Center, both in Denver. "Stress seems to affect asthma symptoms once it's already established, and there was theoretical reason to think it might have a role in onset, but that had not been done."

"It does add new information about an area that we really didn't have a whole lot of information about," says Dr. David A. Khan, assistant professor of internal medicine in the Division of Allergy and Immunology at the University of Texas Southwestern Medical Center in Dallas. "The fact that psychological factors can influence the development of asthma is something that's very intriguing."

The study looked at 145 children, all of whom had a family history of asthma, over their first eight years. Most of their families were middle or upper-middle class and 93 percent of the mothers were Caucasian. By the time the study was completed, 40 children, or 28 percent of the sample, had developed asthma.

Parenting abilities were assessed in 60-to-90-minute interviews with the mothers when the babies were 3-weeks old, way before any asthma symptoms had appeared. The interviewers looked at whether the mothers were depressed, how much support they received from people around them and how responsive and sensitive they were to their children's needs. The study did not include fathers in the assessment, although Klinnert says dads were in the picture most of the time. "We didn't look at dad's interaction but were very interested in how supported mom felt by the dad," she says.

When all was said and done, two main risk factors were associated with asthma onset and persistence: parenting difficulties and serum IgE (immunoglobulin E, an antibody associated with allergic reactions) levels. An elevated IgE level at age 6 months increased the odds of developing asthma later 2.15 times. Parenting difficulties documented when the child was 3 weeks old increased the odds 2.07 times.

As yet, there is only speculation as to why these might be risk factors. Klinnert and her colleagues say a parent who has trouble coping may expose the child to greater emotional stress, which may compromise immune and inflammatory responses; or a parent may not get medical help as early as others.

"I think it clearly suggests the need for more studies looking into these early environmental influences on kids," says Khan, who recently completed a study on asthma and depression. "What we've primarily focused on has been whether they are exposed to certain allergens -- cigarette smoke, cockroaches -- these more physical factors. But I think it's certainly important not to neglect the psychological environment of these children and to see if there is some type of synergistic effect -- whether a combination of allergen plus [psychological environment] has a different effect than either one of these alone."

What To Do

For more information on asthma, visit the American Academy of Allergy, Asthma & Immunology, the Asthma and Allergy Foundation of America or the National Jewish Medical & Research Center.

Need some parenting tips? Try the Child Welfare League of America.

SOURCES: Interviews with Mary Klinnert, Ph.D., associate faculty member, Department of Pediatrics, National Jewish Medical & Research Center and associate professor, Department of Psychiatry, University of Colorado Health Sciences Center, both in Denver, and David A. Khan, assistant professor of internal medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas; October 2001 Pediatrics
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