Breathe easy, think clearly: the relationships between maternal asthma, maternal mental health and infant development

We are beginning to realise just how interconnected our mental and physical health are, and explanatory models are becoming more biobehavioural. The nature of these interactions during pregnancy and the implications for child development are less well known. As such, this thesis aimed to characterise the nature, course and relationships of maternal asthma and maternal mental health in women during pregnancy and in the first few weeks post-partum, and the implications of each on infant development in the first year of life. In this thesis, these relationships were explored by way of a systematic review, two cross-sectional studies and one longitudinal, observational study. The systematic review examined the available literature on the cognitive and behavioural development of children born to mothers with asthma, and showed that there is weak evidence for a relationship between maternal asthma during pregnancy and poor developmental outcomes in children. To further investigate the relationships between maternal asthma, mental health and child development, we prospectively followed up cohorts of mothers with and without asthma. Both populations were followed up at 6 weeks, 6 months and 12 months postpartum. This thesis showed that pregnant women with asthma frequently report issues with psychological distress during the pre- and post-natal periods, and that subjective perception of asthma control may be more closely related to psychopathology than objective asthma measures. To investigate infant development in more detail, we assessed the cognitive, linguistic and motor development of 6- and 12-month old infants with the Bayley Scales of Infant and Toddler Development, and examined habituation and joint attention ability using eye tracking paradigms. It was found that maternal asthma during pregnancy and maternal mental health during and after pregnancy were largely not associated with atypical infant cognitive, linguistic or motor development. Together, these findings send a positive message regarding the implications of maternal asthma and mental health on child development, particularly as the worldwide prevalence of asthma and mental health conditions are increasing.