Associations among maternal childhood socioeconomic status, cord blood IgE levels, and repeated wheeze in urban children

Background Independent of current socioeconomic status (SES), past maternal SES might influence asthma outcomes in children. Objective We examined associations among the mother’s SES in the first 10 years of her life (maternal childhood SES), increased cord blood IgE levels (upper 20% [1.37 IU/mL]),...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2011-08, Vol.128 (2), p.337-345.e1
Main Authors: Sternthal, Michelle J., PhD, Coull, Brent A., PhD, Chiu, Yueh-Hsiu Mathilda, ScD, Cohen, Sheldon, PhD, Wright, Rosalind J., MD, MPH
Format: Article
Language:English
Subjects:
Adult
Age
Allergy and Immunology
Asthma - immunology
Asthma - physiopathology
Biological and medical sciences
Blood
Child, Preschool
Childhood socioeconomic status
childhood wheeze
Children & youth
Chronic obstructive pulmonary disease, asthma
cord blood IgE
Education
Educational attainment
Female
Fetal Blood - immunology
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Health facilities
Home ownership
Humans
Immunoglobulin E - blood
Immunopathology
Infant
Infant, Newborn
inner-city
intergenerational
life course
Medical sciences
Pneumology
Pregnancy
Prenatal Exposure Delayed Effects - immunology
Respiratory Sounds - immunology
Risk
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Social Class
Socioeconomic factors
Stress, Psychological - immunology
Stress, Psychological - pathology
structural equation models
Trauma
Urban Population - statistics & numerical data
Womens health
Young Adult
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Summary:Background Independent of current socioeconomic status (SES), past maternal SES might influence asthma outcomes in children. Objective We examined associations among the mother’s SES in the first 10 years of her life (maternal childhood SES), increased cord blood IgE levels (upper 20% [1.37 IU/mL]), and repeated wheeze (≥2 episodes by age 2 years) in an urban pregnancy cohort (n = 510). Methods Data on sociodemographics, discrimination, financial strain, community violence, interpersonal trauma, and other negative events were obtained prenatally. Prenatal household dust was assayed for cockroach and murine allergens, and traffic-related air pollution was estimated by using spatiotemporal land-use regression. Maternal childhood SES was defined by parental home ownership (birth to 10 years). Maternally reported child wheeze was ascertained at 3-month intervals from birth. Using structural equation models, we examined whether outcomes were dependent on maternal childhood SES directly versus indirect relationships operating through (1) cumulative SES-related adversities, (2) the mother’s socioeconomic trajectory (adult SES), and (3) current prenatal environmental exposures. Results Mothers were largely Hispanic (60%) or black (28%), 37% had not completed high school, and 56% reported parental home ownership. When associations between low maternal childhood SES and repeated wheeze were examined, there were significant indirect effects operating through adult SES and prenatal cumulative stress (β = 0.28, P  = .003) and pollution (β = 0.24, P  = .004; P value for total indirect effects ≤ .04 for both pathways). Low maternal childhood SES was directly related to increased cord blood IgE levels (β = 0.21, P  = .003). Maternal cumulative adversity (interpersonal trauma) was also associated with increased cord blood IgE levels (β = 0.19, P  = .01), although this did not explain maternal childhood SES effects. Conclusion Lower maternal childhood SES was associated with increased cord blood IgE levels and repeated wheeze through both direct and indirect effects, providing new insights into the role of social inequalities as determinants of childhood respiratory risk.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2011.05.008