Stress during Pregnancy and Offspring Pediatric Disease: A National Cohort Study

Background: Identifying risk factors for adverse health outcomes in children is important. The intrauterine environment plays a pivotal role for health and disease across life. Objectives: To conduct a comprehensive study to determine whether common psychosocial stress during pregnancy is a risk factor of a wide spectrum of pediatric diseases in the offspring. Methods: The study was conducted in a population-based sample of mothers with live singleton births (N=66203, 71.4% of those eligible) from the Danish National Birth Cohort, using prospective data. We estimated the association between maternal stress during pregnancy (classified based on two a priori defined indicators of common stress forms, life stress and emotional stress) and offspring diseases during childhood (grouped into 16 categories of ICD-10 diagnoses based on data from national registries), controlling for maternal stress after pregnancy. Results: Median age at end of follow-up was 6.2 (3.6-8.9) years. Life stress (highest compared to lowest quartile) was associated with an increased risk of conditions originating in the perinatal period [odds ratio (OR)=1.13; 95% confidence interval (CI)=1.06-1.21] and congenital malformations (OR=1.17; CI=1.06-1.28), and of the first diagnosis of infection [hazard ratio (HR)=1.28; CI=1.17-1.39], mental disorders (age 0-2.5 years: HR=2.03; CI=1.32-3.14), eye (age 0-4.5 years: HR=1.27; CI=1.06-1.53), ear (HR=1.36; CI=1.23-1.51), respiratory (HR=1.27; CI=1.19-1.35), digestive (HR=1.23; CI=1.11-1.37), skin (HR=1.24; CI=1.09-1.43), musculoskeletal (HR=1.15; CI=1.01-1.30), and genitourinary diseases (HR=1.25; CI=1.08-1.45). Emotional stress was associated with an increased risk for the first diagnosis of infection (HR=1.09; CI=1.01-1.18) and a decreased risk for the first diagnosis of endocrine (HR=0.81; CI=0.67-0.99), eye (HR=0.84; CI=0.71-0.99), and circulatory diseases (age 0-3 years: HR=0.63; CI=0.42-0.95). Conclusions: Maternal life stress during pregnancy be a common risk factor for impaired child health. The results suggest new approaches to reduce childhood diseases.