The goal of this review is to give an update on our increasing understanding of the impact of stress during pregnancy and early development on the emergence of asthma-related characteristics throughout childhood, adolescence, and early adulthood. Recent systematic reviews and meta-analyses, including numerous prospective epidemiological and case–control studies, show that prenatal stress and stress in early childhood have a significant effect on the development of wheeze, asthma, and other atopic-related disorders, with many studies demonstrating an exposure–response relationship. The effect of stress on a child’s wheeze/asthma can also be altered by adjusting the time of exposure. Furthermore, prenatal stress might amplify the effect of chemical stressors, such as prenatal traffic-related air pollution, on the risk of juvenile respiratory illness. Although the relationship between prenatal stress and childhood asthma-related traits is now well established, the processes through which stress predisposes children to chronic respiratory diseases are less clear. Mechanisms important in the pathophysiology of wheeze/asthma and lung growth and development overlap and include a cascade of events including altered immunological, neuroendocrine, and autonomic function, as well as oxidative stress.
Mechanistic studies that examine biomarkers indicating changes across interconnected stress response systems and associated regulatory mechanisms in pregnant women and early children might be very revealing. Understanding the physiological changes caused by stress throughout sensitive life stages that contribute to the risk of chronic respiratory illness might lead to the development of preventative methods and innovative treatment approaches.