Date of Original Version
J Allergy Clin Immunol 2009;124:954-60
Abstract or Table of Contents
Background: Prenatal stress affects immunocompetence in offspring, although the underlying mechanisms are not well understood. Objective: We sought to examine associations between maternal lifetime interpersonal trauma (IPT) and cord blood total IgE levels in a sample of urban newborns (n 5 478). Methods: Maternal IPT during childhood and adolescence (birth to 17 years), adulthood (18 years to index pregnancy), and the index pregnancy were ascertained by using the Revised Conflict Tactics Scale at 28.4 6 7.9 weeks’ gestation. Cord blood IgE levels were derived by using a fluoroenzyme immunoassay. We examined effects of maternal IPT on increased cord blood IgE levels (upper quartile, 1.08 IU/mL) by using logistic regression, adjusting for confounders and mediating variables. Results: Maternal trauma was categorized as unexposed (n 5 285 [60%]), early (childhood and/or teenage years only, n 5 107 [22%]), late (adulthood and/or index pregnancy only, n 5 29 [6%]), and chronic (early and late, n 5 57 [12%]) exposure. Relative to no IPT, early (odds ratio [OR], 1.78; 95% CI, 1.05- 3.00) and chronic maternal IPT (OR, 2.25; 95% CI, 1.19-4.24) were independently associated with increased IgE levels in unadjusted analyses. When adjusting for standard controls, including maternal age and race, season of birth, child’s sex, and childhood and current socioeconomic status, early effects became nonsignificant (OR, 1.48; 95% CI, 0.85-2.58). Chronic exposure remained significant in fully adjusted models, including standard controls, current negative life events, allergen exposure, and potential pathway variables (maternal atopy, prenatal smoking, and birth weight; OR, 2.18; 95% CI, 1.06-4.50). Conclusion: These data link chronic trauma over the mother’s life course with increased IgE levels in infants at birth. Research examining associations between maternal trauma and indicators of offspring’s atopic risk might be particularly relevant in inner- city high-risk populations.