CHEST Guidelines-Maternal-Distress-and-Allergic-Disease

Maternal-Distress-and-Allergic-Disease_chest (1)

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The document explores the impact of maternal distress on the development of allergic diseases, such as asthma and atopic dermatitis (AD), in children. Attention is drawn to the rise of asthma and atopic diseases, heavily linked to increased urbanization and decreased exposure to pathogens due to industrialization and the use of antibiotics. The study highlights the wide range of environmental and psychosocial stressors that contribute to these health issues, although mechanisms remain unclear.<br /><br />Air pollution and early childhood exposure to antibiotics significantly increase asthma and atopic disease incidences, particularly through gene-environment interactions. Children with certain genetic predispositions to allergies face higher risks when exposed to pollution or tobacco, illustrating this interaction. Research also shows that psychosocial stressors before and after birth can exacerbate these conditions by altering cortisol pathways and immune responses.<br /><br />The document references a specific study by van der Leek et al. conducted on 12,587 children in Manitoba, Canada, examining the link between maternal psychological distress during prenatal and postnatal periods and the prevalence of asthma and AD. The study reveals significant associations between maternal distress and increased incidence of these allergic diseases, though the precise impact of environmental exposures remains inadequately addressed due to analytic constraints, such as "butterfly bias."<br /><br />The discussion prompts considerations about integrating perinatal support interventions to mitigate children's risks of developing allergic diseases, emphasizing socioeconomic and racial disparities in healthcare outcomes. Caution is advised against overemphasizing maternal responsibility for children's health outcomes, to avoid additional stress on already vulnerable populations. The document underscores the importance of examining both maternal distress and broader environmental factors to develop a comprehensive understanding of allergic disease pathogenesis.

Keywords

maternal distress

allergic diseases

asthma

atopic dermatitis

urbanization

gene-environment interactions

psychosocial stressors

cortisol pathways

perinatal support

healthcare disparities