Psychosocial factors contribute to development of asthma in genetically at-risk children, study finds

October 01, 2001

ROCHESTER, MINN. -- A new prospective study finds that early parenting difficulties are associated with the development of asthma in genetically at-risk children between the ages of six and eight. The study in which Mayo Clinic participated, appears in the October issue of Pediatrics.

Asthma is an allergic condition that causes labored breathing and can be life-threatening. It is the most common chronic illness of childhood, according to an article on MayoClinic.com. Its prevalence has risen sharply in inner-city children over the past decade. One in nine children now has the condition.

"The fact that parenting difficulties assessed in the first three weeks of life were significantly and independently associated with asthma at school age is a remarkable and previously unreported finding," says David Mrazek, M.D., chair of Mayo Clinic's Department of Psychiatry and Psychology and an author on the paper.

Parenting difficulties include maternal depressed mood and coping problems, relationship conflicts, absence of social support, and problems providing sensitive and responsive care taking. Parenting difficulties generally focus on the emotional care-giving environment, not on external stresses.

Investigators from the National Jewish Medical and Research Center, Mayo Clinic and Colorado Allergy and Asthma Centers have studied this group of 150 children with a family history of asthma for eight years. The children were considered genetically at risk for asthma because all their mothers and some of their fathers had asthma.

"Asthma is a complex disease with many contributing factors," said Mary Klinnert, Ph.D., National Jewish pediatric psychologist and lead author of the study. "Many of the children in our study with well-adjusted, caring, effective parents still developed asthma. But our results do indicate that the psychological environment of the child may play a role in the development of asthma."

Researchers originally assessed study participants for medical and psychosocial functioning during the third trimester of pregnancy. Before the infants developed any symptoms of asthma, an experienced clinician conducted a home visit to assess parenting difficulties when the infants were three weeks old.

Parents were rated on a three-point scale:


1) things are going OK;
2) there are potential problems that should be reassessed; and
3) there are clear problems in the care and emotional environment of the child.

Of the 150 children studied, 40 (28 percent) had developed asthma by the time they were between six and eight years of age. Children whose parents coped poorly with the demands of parenting during their baby's first weeks of life were more than twice as likely to develop asthma than were children whose parents were assessed as parenting adequately.

"Human emotions are powerful, even though we sometimes try to deny it," Dr. Mrazek says. "But this study shows that emotional distress experienced early in life can have long-term health consequences. It's important not to blame parents, but to support them in doing their best to provide a nurturing environment."

In other findings, the study also corroborates previous reports that an elevated blood level of the antibody immunoglobulin E is associated with later development of asthma is this at-risk group.
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Mayo Clinic

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