Trajectories of psychosocial environmental factors and their associations with asthma symptom trajectories among children in Australia.

Introduction: Several psychosocial factors, such as maternal mental health and parents' financial hardship, are associated with asthma symptoms among children. So, we aim to investigate the changing patterns of important psychosocial environmental factors and their associations with asthma symptom trajectories among children in Australia.

Methods: We considered asthma symptoms as wheezing (outcome) and psychosocial environmental factors (exposures) from 0/1 year to 14/15 years of the participants from the "Longitudinal Study of Australian Children (LSAC)" for this study. We used group-based trajectory modeling to identify the trajectory groups for both exposure and outcome variables. Associations between psychosocial factors and three distinct asthma symptom trajectories were assessed by multivariable logistic regression.

Results: We included 3917 children from the LSAC birth cohort in our study. We identified distinct trajectories for maternal depression, parents' financial hardship, parents' stressful life events and parents' availability to their children from birth to 14/15 years of age. Compared to the "low/no" asthma symptom trajectory group, children exposed to a "moderate & increasing" maternal depression, "moderate & declining" parents' financial hardship, and "moderate & increasing" parents' stressful life events were significantly associated (relative risk ratio [RRR]: 1.55, 95% confidence interval [CI]: 1.27, 1.91; RRR: 1.40, 95%; CI: 1.15, 1.70; RRR: 1.77, 95%; CI: 1.45, 2.16) with "persistent high" asthma symptom trajectory.

Conclusion: Several psychosocial factors that are potential stressors for mental health increase the risk of having an adverse asthma symptom trajectory during childhood. Further attention should be given to reducing exposure to maternal depression, parents' financial hardship, and parents' stressful live events for long-term asthma control in children.