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Family Troubles May Trigger Asthma in Susceptible Children, Study Says

May 5, 1992

WASHINGTON (AP) _ Children with a genetic predisposition to asthma may be more likely to develop the disease by age 3 if their families show certain psychological difficulties, a new study says.

Researchers found that several measures of family functioning and psychological health when a baby was three weeks old were linked to the child’s risk of developing asthma by age 3.

It is not yet clear how those factors interact with other risk factors for developing asthma, said Dr. David Mrazek.

The study result may reflect a direct effect of stress on the child, or the family troubles may affect parental behavior in a way that makes the child more likely to be exposed to physical triggers for asthma, he said.

He also noted that the study focused on a largely white, middle-class sample in which at least one parent was asthmatic, and said the result may not pertain to other groups.

But the result, while preliminary, ″really does begin to introduce an optimistic note″ by suggesting that treating the family problems may decrease the asthma risk, he said.

Mrazek is chief of psychiatry and behavioral sciences at the Children’s National Medical Center in Washington. He did the work with Mary Klinnert of the National Jewish Center for Immunology and Respiratory Medicine in Denver.

Mrazek presented the work Tuesday at a meeting of the American Psychiatric Association.

Dr. Robert Mellins, director of the pediatric pulmonary division at Columbia-Presbyterian Medical Center in New York, said he could not comment directly on the study without inspecting the data. But ″most of us have the impression that most of the time, the psychological and emotional factors are not the primary ones in the induction of asthma,″ he said in a telephone interview.

About 15 million Americans have asthma, which produces episodes that make it difficult to breathe.

Genes play a role in asthma but it is not clear how many are involved, Mrazek said in an interview. A child runs about a 20 percent chance of developing asthma if one parent has the disease and about a 50 percent chance if both parents do, he said. If neither parent has asthma, the child’s risk is less than 5 percent, he said.

Of people who get asthma as children, about two-thirds get it by age 3 and about 75 percent by age 5, he said.

The new study followed 150 children from before birth through age 3. Each had at least one asthmatic parent. A little more than half the children were firstborns, and about a third were second children.

When the children were three weeks old, before any trace of asthma could appear, researchers visited the families and interviewed the parents.

They looked for signs of three factors: significant marital discord, persistent depression in the mother that went beyond the common ″baby blues″ and impeded her ability to function, and parental problems in day-to-day baby care and planning of ongoing care.

By age 3, 33 of the 150 infants developed asthma. Analysis showed that their risk of asthma was 42 percent if their parents had shown at least two of the risk factors, and 17 percent if the parents had shown only one or none.

Thirty-two couples had shown at least two risk factors.

Researchers have not yet analyzed their data on other factors that can predispose children to asthma, such as their history of respiratory infections and their exposure to tobacco smoke and to allergy-provoking substances, Mrazek said.

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