Parental stress interaction with environmental factors in childhood allergic asthma: Early life significance

Abstract

Although stress and indoor/outdoor environments have been independently linked with asthma, their interactions on childhood physician-diagnosed allergic asthma (PDAA) remain undisclosed. We aimed to research the effect of parental stress and their interactions with indoor/outdoor environmental factors on childhood PDAA. A retrospective cohort study was undertaken of preschoolers at Changsha, a city in central China. We collected information on parental stress levels and various indoor environmental exposures, through questionnaire surveys. Outdoor air pollution exposure was obtained from ten ambient pollution monitoring stations in Changsha, and individual pollution exposure were calculated. Using logistic regression models, we assessed the individual and synergistic impacts of parental stress and indoor/outdoor factors on childhood PDAA. We found that preschoolers' PDAA showed a significant association with high parental gross annual income and psychological stress indicators including fatigue, headache, and inattention, with ORs = 2.10 (1.31–3.35), 1.38 (1.04–1.82), 1.33 (1.07–1.65), and 1.42 (1.14–1.76), respectively. Furthermore, in preschoolers with high parental economic stress, the association between indoor mold/moisture spots and PDAA was notably more pronounced. Significantly stronger association between outdoor SO₂ exposure in the past year in preschoolers with socially stressed parents. Parental headache and inattention exacerbated the effects of PM_2.5-10 and PM₁₀ exposure during the 7-9th months before pregnancy and throughout the pregnancy on PDAA. Preschoolers with high parental psychological stress and high exposure to outdoor atmospheric pollutants showed an increased likelihood of developing PDAA. Our research suggests that both parental stress and its interaction with hazardous environments from indoor sources and atmospheric pollutants contribute to PDAA.