Parental Stress Associated With Hospitalizations for Asthma and Poor Asthma Symptom Control, Especially for High-Risk Populations

January 10, 2011

Parental stress, particularly depression, is an important risk factor for asthma problems among Puerto Rican children, according to new research led by a pulmonologist at Children’s Hospital of Pittsburgh of UPMC.

In a study of 339 sets of twins from Puerto Rico, maternal and paternal depression were associated with children’s recurrent hospitalizations for asthma and poor control of asthma symptoms. Results of the study are published online in the Journal of Allergy and Clinical Immunology.

The study was led by Juan Celedón, M.D., Dr.P.H., chief of the Division of Pediatric Pulmonary Medicine, Allergy and Immunology at Children’s Hospital and the Niels K. Jerne Professor of Pediatrics and Medicine at the University of Pittsburgh School of Medicine.

According to the study, children whose mothers had depression were at increased risk of asthma hospitalizations at 1 and 3 years of age, and an increased prevalence of asthma diagnosis at age 3. At 1 and 3 years of age, children whose fathers had depression experienced increased oral steroid use and there was an association between parental depression and hospitalizations.

“Our findings add to the growing body of evidence of a link between stress in the family and the development of asthma in children and subsequent poor symptom control,” Dr. Celedón said. “Addressing parental psychosocial stress, caused by factors such as violence and poverty, may improve rates of hospitalization and asthma symptom control in childhood.”

Asthma is a global health problem that affects more than 6.8 million children in the United States, and Puerto Ricans have the highest lifetime prevalence of asthma. In addition to high rates of asthma, Puerto Ricans have a high prevalence of psychosocial stress, mostly related to exposure to violence and high levels of poverty, with 45 percent of the population living below the poverty level.

In this study, the twins’ parents were interviewed separately about their own stress and about asthma in their children individually at age 1 and again at age 3. Fathers were asked about symptoms of post-traumatic stress disorder, depression and antisocial behavior, while mothers were asked about depressive symptoms.

“To our knowledge, this is the first study to report an independent association between indicators of paternal stress and asthma outcomes in early childhood,” Dr. Celedón said.

Dr. Celedón’s research is funded by the National Institutes of Health. The first author of the study is Nancy E. Lange, M.D., M.P.H., of the Channing Laboratory of Brigham and Women’s Hospital in Boston.

Marc Lukasiak, 412-692-7919,
Anita Srikameswaran, 412 578-9193,