Fetal Programming and Atopic Disease

Fetal Programming of Infant Stress Reactivity and Atopic Disease  

Summary of the Project

This proposed Allergen Strategic Initiative is an extension of the ongoing Fetal Programming study, co-funded by CIHR and the Alberta Centre for Child, Family and Community Research. The Fetal Programming study seeks to examine: (1) the impact of prenatal psychophysiological stress on infant stress reactivity, and (2) potential of optimal postnatal care to moderate any observed association between prenatal psychophysiological stress and infant stress reactivity. The proposed Allergen Strategic Initiative will extend the Fetal Programming study to explore the influence and interactions of maternal psychophysiological stress, infant stress reactivity, and postnatal infant care on the development of the atopic diseases of asthma (wheeze) and dermatitis in infants. The proposed Allergen Strategic Initiative will form the foundation for a future proposal to CIHR that will further explore atopic disease trajectories in the longitudinal sample.

Questions for AllerGen Strategic Initiative

The proposed Allergen extension study seeks funding to address three new research questions:

1. What is the association between exposure to prenatal maternal stress (assessed by maternal self-report of depression, anxiety and stress, cortisol in maternal saliva, and maternal HRHRV) and

1. markers of future atopic disease in the newborn (assessed by cord blood pro-inflammatory cytokines) and 3-month-old infant (assessed by blood pro-inflammatory cytokines)?
2. development of wheeze and atopic dermatitis in 6 and 12 month-old infants (assessed by clinical interview)?

      2.   What is the association between infant stress reactivity (assessed by infant salivary cortisol and       HFHRV in response to stress tests at 3 and 6 months of infant age) and development of wheeze       and atopic dermatitis in the 6 and 12 month-old infants? (assessed by clinical interview)?

      3.   How does maternal caregiving quality influence the identified associations?

Thus far, we have described the association between: perinatal distress and infant interleukins at 3 months of age, (2) interleukins and atopic dermatitis (rash), and (3) built a best fit model from the identified associations in (1) and (2). Perinatal distress is associated with elevated infant ILs. Demographic variables (maternal age, education), IL10, perinatal stressful life events (e.g. separation/divorce, family death) and maternal-infant interaction best predicted skin rash in 18-month-old infants. We have also described the association between the following variables and AD: (1) prenatal and postnatal distress, (2) infant cytokines, and (3) maternal-child interaction, in order to build a best fit model for childhood AD. Elevated maternal postnatal distress, cytokine levels and reduced maternal sensitivity were significantly associated with increased risk for AD. Maternal sensitivity was the best predictor of infant atopic dermatitis at 18 months of age.

Goals and Objectives

Our primary questions seek to address the following:

(1) what is the association between pre- and postnatal depression/anxiety, and childhood atopic dermatitis at 18 months. 

(2) what is the association between mother-child interaction quality and childhood atopic dermatitis at 18 months.

Funded by: 

The Canadian Institutes of Health Research (CIHR)
Alberta Centre for Child, Family & Community Research (ACCFCR)

Members of the Team

PRINCIPAL INVESTIGATORS:

Name and Title: Dr. Nicole Letourneau (PI), Professor and Norlien/ACHF Research Chair in Parent-Infant Mental Health (AllerGen Investigator)

Email Address: Nicole.Letourneau@ucalgary.ca

Name and Title: Dr. Gerald Giesbrecht (PI), Assistant Professor, Dept. of Pediatrics, Univ. of Calgary

Email Address: GGiesbre@ucalgary.ca

Name and Title: Dr. Anita Kozyrskyj (PI), Associate Professor & Research Chair in Maternal-Child Health and the Environment (AllerGen Investigator)

Email Address: Kozyrysky@ualberta.ca
 

RESEARCH CO-INVESTIGATORS:

Name and Title: Dr. Piushkumar Mandhane, Pediatric Respirologist & Assistant Professor

Email Address: Mandhane@ualberta.ca

Name and Title: Dr. Catherine Field, Professor

Email Address: Catherine.Field@ualberta.ca

Name and Title: Dr. Tavis Campbell, Associate Professor

Email Address: T.S.Campbell@ucalgary.ca

Name and Title: Dr. Bonnie Kaplan, Professor, Dept. of Pediatics, University of Calgary

Email Address: Bonnie.Kaplan@albertahealthservices.ca

Name and Title: Dr. Katherine Wynne-Edwards, Professor of Comparative Endocrinology

Email Address: K.Wynne-Edwards@ucalgary.ca