Maternal stress and allergic disease in offspring

The theory of developmental origins of health and disease (DOHaD), hypothesize that diseases like allergy is formed in-utero and early life by interaction between adverse environmental factors and genetic predisposition.

The study population in this thesis consists of mother-child pairs from the PreventADALL cohort. The overall aim of this doctoral thesis was to evaluate maternal pre- and postpartum stress and the risk of abdominal pain and allergic disease in offspring. In Study 1, the proportion of maternal perceived stress at 18- and 34-weeks was described and the association between symptoms of allergic disease and maternal perceived stress explored in n=2164 pregnant mothers. Study 2 described the prevalence of infant colic, abdominal pain and other pain and discomforts in n=1852 infants at 3 months age and perinatal factors associated with the abdominal outcomes. The correlation between maternal perceived stress in pregnancy and postpartum, maternal saliva cortisol and infant saliva cortisol (n=1057) was explored in study 3. Finally, Study 4 investigated if maternal perceived stress during pregnancy or postpartum were associated with infant allergic sensitization at 12 months age (n=1757).

Results from Study 1 showed that maternal stress was reported by 15 % of the mothers at 18 weeks and 13% at 34 weeks. Symptoms of asthma, rhinitis and food allergy reported by the mother were associated with high perceived stress and increased stress in the third trimester. Infant colic was reported in n=59 infants, abdominal pain in n=115 and other pain and discomforts in n=119 infants at 3 months age. High maternal perceived stress was not associated with any of the abdominal and pain symptoms. Neither were the infant saliva cortisol levels at 3 months age (Study 3). Furthermore, maternal perceived stress during pregnancy and postpartum and maternal saliva cortisol at 18 weeks were not correlated, neither were infant saliva cortisol levels (n=1057). In Study 4, infants and their mothers with perceived stress were included. The maternal stress in pregnancy and postpartum were not associated with infant sensitization (n=139) at 12 months age.

Conclusion: Symptoms of allergic disease can be stressful for mothers in pregnancy. Abdominal pain is a common symptom in 3-month-old infants. Maternal stress in pregnancy is not a risk-factor for abdominal pain, other pain and discomforts or infant colic. Maternal perceived stress in pregnancy and postpartum does not correlate with neither maternal cortisol in pregnancy nor infant cortisol at 3 months age. Maternal stress in pregnancy and postpartum is not associated with allergic sensitization in their offspring at 12 months of age.

These findings could be an important information to communicate to the mothers who experience stress during pregnancy. The knowledge that maternal stress does not affect colic, abdominal pain, or allergic sensitization could relieve the mother.

List of scientific papers

I. Olsson Mägi CA, Bjerg Bäcklund A, Lødrup Carlsen K, Almqvist C, Carlsen KH, Granum B, Haugen G, Hilde K, Lødrup Carlsen OC, Jonassen CM, Rehbinder EM, Sjøborg KD, Skjerven H, Staff AC, Vettukattil R, Söderhäll C, Nordlund B. Allergic disease and risk of stress in pregnant women: a PreventADALL study. ERJ Open Res. 2020 Oct 13;6(4):00175-2020.
https://doi.org/10.1183/23120541.00175-2020

II. Despriee ÅW, Olsson Mägi CA, Småstuen MC, Glavin K, Nordhagen L, Jonassen CM, Rehbinder EM, Nordlund B, Söderhäll C, Carlsen KL, Skjerven HO. Prevalence and perinatal risk factors of parent-reported colic, abdominal pain and other pain or discomforts in infants until 3 months of age - A prospective cohort study in PreventADALL. J Clin Nurs. 2022 Oct;31(19- 20):2784-2796.
https://doi.org/10.1111/jocn.16097

III. Olsson Mägi CA, Wik Despriee Å, Småstuen MC, Almqvist C, Bahram F, Bakkeheim E, Bjerg A, Glavin K, Granum B, Haugen G, Hedlin G, Jonassen CM, Lødrup Carlsen KC, Rehbinder EM, Rolfsjord LB, Staff AC, Skjerven HO, Vettukattil R, Nordlund B, Söderhäll C. Maternal Stress, Early Life Factors and Infant Salivary Cortisol Levels. Children (Basel). 2022 Apr 27;9(5):623.
https://doi.org/10.3390/children9050623

IV. Olsson Mägi CA, Almqvist C, Bjerg Backlund A, Tedner G S, Lødrup Carlsen K, Rehbinder EM, Haugen G, Monceyron Jonassen C, Granum B, Staff AC, Skjervn H, Despriee ÅW, Wärberg Gerdin S, Vettukattil R, Söderhäll C, Nordlund B,. Pre- and postpartum maternal perceived stress and allergic sensitization in offspring: A observational population-based Nordic birth cohort study (PreventADALL). [Manuscript]