Effect of maternal sleep, physical activity and screen time during pregnancy on the risk of childhood respiratory allergies: a sex-specific study

Abstract

Background: Early life exposure in the uterus had a long-term effect on children's health. As the prevalence of allergies is increasing with a remarkable sex difference, very few studies have traced back to their early origins. We sought to investigate if maternal behavioral exposure, herein sleep, physical activity, and screen time during pregnancy is associated with childhood respiratory allergies. The sex difference would be examined. Methods: Six thousand two hundred thirty-six mother-child pairs from Shanghai Children Allergy Study (SCAS) were enrolled, The International Study of Asthma and Allergies in Childhood questionnaire was adopted to evaluate respiratory allergic diseases. Results: 14.6, 16.2, and 21.0% of children had asthma, wheeze, and allergic rhinitis, respectively. Maternal short sleep duration, lack of physical activity, and too much screen exposure during pregnancy could increase the risk of childhood respiratory allergies, however, the significance was found only in males. Moreover, a dose-response trend was clearly shown, any two of the three combined could increase the risk (OR,1.921; 95% CI,1.217-3.033), and the coexistence of all three further amplified the risk (OR,2.412; 95% CI,1.489-3.906). The findings can be verified in allergen test subgroup and each single type of respiratory allergies in most cases. Conclusions: Maternal unhealthy behaviors during pregnancy could increase the risk of childhood respiratory allergies with a dose-response pattern. Males were more susceptible to the association. The identification of modifiable maternal risk behaviors lies in the emphasis of intervention in early life to face up increasing childhood allergies.

Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort

“…Consistent with earlier studies [ 12 , 14 , 23 , 27 , 40 , 42 ], this study also found that maternal asthma during pregnancy, smoking during pregnancy, and pre-pregnancy obesity were significantly associated with increased risks of wheezing and asthma among Australian children. Childhood eczema was associated only with maternal asthma during pregnancy and not with pre-pregnancy obesity, smoking during pregnancy, or antibiotic/antidepressant medication use during pregnancy.…”

“…Based on existing literature [ 3 , 13 , 14 , 32 ], this study considered the following confounding variables. Socio-demographic covariates included were (i) age of the mother (<=18, 19–34, > = 35 years), (ii) gender of the child (male or female), (iii) whether English is spoken at home (yes or no), (iv) whether mother is married with a partner, with a de facto partner, or single, (vi) indigenous status (yes or no), (vii) education of the mother (year 12 or less, professional qualification, graduate diploma, or postgraduate), (viii) family income (five quantiles), and (ix) remoteness of the family residence (highly accessible, accessible/moderately accessible, or remote/very remote).…”

“…Although prenatal or postnatal smoking is a significant risk factor for wheezing and asthma among infants and preschool-age children [ 27 , 30 ], it is not well known how the number of cigarettes smoked during pregnancy effects the association. Some studies have shown that maternal use of medications, which includes paracetamol use [ 31 ] or high doses of folic acid [ 29 ] during pregnancy had influenced health outcomes in children such as increased risk of childhood asthma [ 14 , 32 ]. However, few studies have examined the effects of anti-depressant or antibiotic medication use during pregnancy on childhood wheezing, asthma or eczema [ 31 , 33 ].…”

“…However, these studies only focused on prevalence and lacked investigation on the sex-specific associations of familial heredity or maternal health during pregnancy. Few studies have used a single population-based prospective study on both respiratory and allergic diseases [ 36 , 37 ], or adjusted for confounding factors of maternal health during pregnancy to determine the age and sex-specific effects on children’s respiratory and allergic diseases [ 14 , 25 ]. Longitudinal investigation of sex differences of wheezing, asthma and eczema in Australian children (birth to 15 years of age), associated with maternal health during pregnancy, is limited.…”

“…Wheezing, asthma and eczema [4] pose significant long-term health burdens to children, such as poor lung function or development of persistent asthma in later life [5][6][7][8]. Furthermore, the incidences of wheezing, asthma or eczema are influenced by maternal health and environmental conditions [9][10][11] which include maternal exposures to asthma, obesity, antibiotic/antidepressant medication use or smoking during pregnancy [4,8,[12][13][14][15][16]. Therefore, comprehensive research related to longitudinal prevalence of wheezing, asthma, and eczema among children, taking maternal health during pregnancy into account, is a public health priority.…”