Joint and independent associations of maternal childhood trauma and prenatal stress with child respiratory outcomes.

INTRODUCTION: A mother's childhood traumatic events (CTEs) and stressful life events (SLEs) during pregnancy independently have been associated with offspring wheeze and asthma. However, their combined influence on childhood airway outcomes, including lung function, remains unclear. METHODS: Participants included 341 mother-child dyads from The Infant Development and the Environment Study. Mothers retrospectively reported CTEs and SLEs. At age 12, children completed spirometry and respiratory questionnaires. We estimated risk ratios for ever asthma, ever wheeze, and wheeze in the last 12 months, and linear regression coefficients for FEV1/FVC and FEF25-75. Models included CTEs and SLEs simultaneously and CTE × SLE and stress×sex interactions. RESULTS: CTEs and SLEs were not individually associated with ever wheeze (RR = 1.27 [0.98-1.64] and 1.04 [0.91-1.20], respectively), wheeze in the last 12 months (RR = 1.00 [0.56-1.76] and 1.17 [0.98-1.39], respectively), or ever asthma (RR = 0.99 [0.71-1.39] and 1.15 [1.00 to 1.32], respectively). An antagonistic interaction was observed for ever wheeze (p = 0.03) and wheeze in the last 12 months (p = 0.04) with the greatest risk among those with either high stress or trauma measures during childhood (CTE) or pregnancy (SLE), but not both. Neither exposure was associated with lung function, and no interactions by sex were observed. CONCLUSION: Maternal childhood trauma and prenatal stress independently were not associated with airway outcomes at age 12. An antagonistic interaction of stress during both periods suggests that mismatches in stress exposures across maternal life stages may shape offspring respiratory health. Given small event counts and limited adversity range, replication is needed before clinical implications can be drawn.