Transdisciplinary research strategies for understanding socially patterned disease: the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project as a case study

Wright, Rosalind J.; Suglia, Shakira F.; Levy, Jonathan I.; Fortun, Kim; Shields, Alexandra E.; Subramanian, S. V.; Wright, Robert O.

doi:10.1590/s1413-81232008000600008

Cited by 57 publications

(42 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Participants were from the Asthma Coalition on Community, Environment and Social Stress (ACCESS) project, a pregnancy cohort designed to examine the effects of perinatal exposure to physical toxins and psychosocial stress on urban childhood respiratory health (33). In brief, English-or Spanish-speaking pregnant women (>18 yr old) receiving care at Brigham and Women's Hospital, Boston Medical Center, and affiliated community health centers were enrolled at 28.4 6 7.9 weeks gestation between August 2002 and July 2009.…”

Section: Methodsmentioning

confidence: 99%

Prenatal Particulate Air Pollution and Asthma Onset in Urban Children. Identifying Sensitive Windows and Sex Differences

Hsu¹,

Chiu²,

Coull

et al. 2015

Am J Respir Crit Care Med

Self Cite

266

104

View full text Add to dashboard Cite

Rationale: The influence of particulate air pollution on respiratory health starts in utero. Fetal lung growth and structural development occurs in stages; thus, effects on postnatal respiratory disorders may differ based on timing of exposure.Objectives: We implemented an innovative method to identify sensitive windows for effects of prenatal exposure to particulate matter with a diameter less than or equal to 2.5 mm (PM 2.5 ) on children's asthma development in an urban pregnancy cohort.Methods: Analyses included 736 full-term (>37 wk) children. Each mother's daily PM 2.5 exposure was estimated over gestation using a validated satellite-based spatiotemporal resolved model. Using distributed lag models, we examined associations between weekly averaged PM 2.5 levels over pregnancy and physician-diagnosed asthma in children by age 6 years. Effect modification by sex was also examined.Measurements and Main Results: Most mothers were ethnic minorities (54% Hispanic, 30% black), had 12 or fewer years of education (66%), and did not smoke in pregnancy (80%). In the sample as a whole, distributed lag models adjusting for child age, sex, and maternal factors (education, race and ethnicity, smoking, stress, atopy, prepregnancy obesity) showed that increased PM 2.5 exposure levels at 16-25 weeks gestation were significantly associated with early childhood asthma development. An interaction between PM 2.5 and sex was significant (P = 0.01) with sex-stratified analyses showing that the association exists only for boys.Conclusions: Higher prenatal PM 2.5 exposure at midgestation was associated with asthma development by age 6 years in boys. Methods to better characterize vulnerable windows may provide insight into underlying mechanisms.

show abstract

Section: Methodsmentioning

confidence: 99%

Prenatal Particulate Air Pollution and Asthma Onset in Urban Children. Identifying Sensitive Windows and Sex Differences

Hsu¹,

Chiu²,

Coull

et al. 2015

Am J Respir Crit Care Med

Self Cite

266

104

View full text Add to dashboard Cite

show abstract

“…Subjects were from the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project—a prospective pregnancy cohort designed to investigate the effects of early life stress and other environmental factors on urban childhood asthma risk 23. Briefly, English or Spanish speaking pregnant women receiving prenatal care were recruited from Brigham and Women's Hospital (BWH), Boston Medical Center, three urban community health centres and their affiliated Women, Infants and Children programmes in the Boston metropolitan area between August 2003 and January 2007.…”

Section: Methodsmentioning

confidence: 99%

Influence of experiences of racial discrimination and ethnic identity on prenatal smoking among urban black and Hispanic women

Nguyen

Subramanian

Sorensen

et al. 2010

J Epidemiol Community Health

View full text Add to dashboard Cite

show abstract

“…Between August 2002 and September 2009, English-or Spanishspeaking women receiving prenatal care at two Boston hospitals and affiliated community health centers were recruited into the Asthma Coalition on Community, Environment, and Social Stress project, a pregnancy cohort examining the effects of perinatal stress and other environmental factors on urban childhood asthma risk (21). Among women approached in mid-to-late pregnancy (28.4 6 7.9 wk gestation) who were eligible, 989 (78.1%) agreed to enroll.…”

Section: Study Participantsmentioning

confidence: 99%

Prenatal and Postnatal Maternal Stress and Wheeze in Urban Children

Chiu¹,

Coull

Cohen

et al. 2012

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Rationale: Critical periods for programming early wheeze risk may include pregnancy and infancy. Effects of timing remain poorly understood. Objectives: Associations among prenatal and postnatal maternal stress and children's wheeze were prospectively examined in 653 families. Effect modification by maternal sensitization was also examined. Methods: Stress was indexed by a maternal negative life events (NLEs) score (range, 0-9) ascertained during pregnancy and between 1 and 2 years postpartum. Mothers reported child wheeze every 3 months up to age 2 years. Relationships of prenatal and postnatal maternal NLEs with repeated wheeze (>2 episodes) were examined using logistic regression adjusting for covariates. Penalized splines were implemented to explore possible nonlinear associations. We also examined the interaction between prenatal stress and maternal sensitization indexed by allergen-specific IgE from maternal prenatal serum. Measurements and Main Results: Adjusted models considering prenatal or postnatal NLEs alone both showed an exposure-response relationship between higher stress and child wheeze. When considering prenatal and postnatal stress concurrently, only children of mothers with high stress in both periods were significantly more likely to wheeze (adjusted odds ratio, 3.04; 95% confidence interval, 1.67-5.53) than children of mothers reporting low stress in both periods. Associations between high prenatal stress and wheeze were significant in children born to nonsensitized mothers (any IgE ,0.35 kU/L) but not in the sensitized group (P for interaction ¼ 0.03). Conclusions: Although children have heightened sensitivity to maternal stress in utero and in early childhood, those with higher stress in both periods were particularly at risk for wheeze. The prenatal maternal immune milieu modified effects.Keywords: negative life events; stress; pregnancy; maternal sensitization; childhood wheeze Childhood wheezing illnesses account for significant morbidity and health care use (1). Recurrent wheeze may be a precedent of asthma and reduced lung function (2). An important step in identifying children at risk for costly respiratory disorders is characterizing risk factors and mechanisms that lead to and maintain early predisposition.Although the spectrum of wheeze phenotypes is complex and mechanisms of early environmental influences are incompletely understood (3, 4), aberrant proinflammatory states are central determinants (5, 6). Glucocorticoid action and sympathovagal balance are important in regulating immune function and airway response in early development (7,8). Thus, environmental factors, such as psychosocial stressors, that influence the programming of regulatory systems involved in these processes (i.e., hypothalamic-pituitary-adrenal [HPA] axis, autonomic nervous system, immune function) may be particularly relevant.Evidence links psychosocial stress to wheeze, asthma, and airway hyperesponsiveness (9). Animal studies suggest effects begin prenatally. Prenatal stress increases allergen-induced ...

show abstract

Transdisciplinary research strategies for understanding socially patterned disease: the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project as a case study

Cited by 57 publications

References 65 publications

Prenatal Particulate Air Pollution and Asthma Onset in Urban Children. Identifying Sensitive Windows and Sex Differences

Prenatal Particulate Air Pollution and Asthma Onset in Urban Children. Identifying Sensitive Windows and Sex Differences

Influence of experiences of racial discrimination and ethnic identity on prenatal smoking among urban black and Hispanic women

Prenatal and Postnatal Maternal Stress and Wheeze in Urban Children

Contact Info

Product

Resources

About