Maternal childhood and lifetime traumatic life events and infant bronchiolitis

• Authors: Margaret A Adgent, Vanderbilt University; Omar Elsayed-ali, Emory University; Tebeb Gebretsadik, Vanderbilt University; Frances A Tylavsky, University of Tennessee Health Science Center; Mehmet Kocak, University of Tennessee Health Science Center; Stephania A Cormier, Louisiana State University; Rosalind J Wright, Icahn School of Medicine at Mount Sinai, New York; Kecia N Carroll, Vanderbilt University School of Medicine
• Journal Title: PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
• Volume: Volume 33, Number 4
• Publisher: Wiley | 2019-06-17, Pages 262-270
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1111/ppe.12559
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Intergenerational; Psychological Trauma; Trauma and Stressor Related Disorders; Infant; Respiratory Tract Diseases

Abstract

Background Viral bronchiolitis is a common respiratory infection that often affects term, otherwise healthy infants. A small literature suggests maternal stress during pregnancy is associated with bronchiolitis. However, the association between maternal exposure to lifetime traumatic stress, including traumatic events occurring in childhood or throughout the life-course, and bronchiolitis has not been studied previously. Objectives To investigate the association between maternal exposure to total lifetime and childhood traumatic stress events and infant bronchiolitis. Methods We studied mother-infant dyads enrolled in a prospective prenatal cohort, recruited 2006–2011, and Tennessee Medicaid. During pregnancy, we assessed maternal lifetime exposure to types of traumatic events by questionnaire. We captured bronchiolitis diagnoses in term, non-low birthweight infants’ first 12 months using linked Medicaid data. In separate models, we assessed the association of maternal lifetime traumatic events (0 to 20 types) and a subset of traumatic events that occurred during childhood (0 to 3: family violence, sexual and physical abuse) and infant bronchiolitis using multivariable log-binomial models. Results Of 629 women, 85% were African-American. The median count (interquartile range) of lifetime traumatic events was 3 (2, 5); 42% reported ≥1 childhood traumatic event. Among infants, 22% had a bronchiolitis diagnosis (0 to 2 lifetime traumatic events: 24%; 3 events: 20%; 4 to 5 events: 18%; 6 or more events: 24%). Total maternal lifetime traumatic events were not associated with bronchiolitis in multivariable analyses. For maternal childhood traumatic events, the risk of infant bronchiolitis increased with number of event types reported: adjusted Risk ratios were 1.12 (95% confidence interval [CI] 0.80, 1.59), 1.31 (95% CI 0.83, 2.07), and 2.65 (95% CI 1.45, 4.85) for 1, 2 and 3 events, respectively, versus none. Conclusions Infants born to women reporting multiple types of childhood trauma were at higher risk for bronchiolitis. Further research is needed to explore intergenerational effects of traumatic experiences.