Maternal distress and childhood asthma: Does it matter if women attribute risk to genetics or the environment?

The diseases of greatest impact on our society¿s morbidity and mortality are not the rare, single gene diseases, but the common, genetically complex diseases, such as asthma. Complex genetic diseases arise from the interaction of many genes and environmental factors, and not from mutations in single genes. Thus, the risk for developing asthma cannot be stated with absolute certainty. Finding a genetic basis for asthma has the potential to decrease mother-blame for the disease, as had happened in the 1960s with the use of the term ¿asthmatogenic mother¿ to describe a mother who caused asthma in her child through her pathological parenting style. On the other hand, the "geneticization" of asthma ignores changes required to environmental causes of the disease. In summary, genetics research on complex disorders raises questions on the psychological, social, ethical, and legal implications of this research. Our primary objective is to study current societal knowledge on the genetic and environmental contributors of postpartum distress and its relationship to childhood asthma, with the goal of assessing the public health, social, and ethical impacts of the emerging awareness of the connection between the two. We plan to evaluate this knowledge in four populations of women: 1) pregnant women with distress in British Columbia, 2) postpartum women with distress in New Brunswick, Alberta and Manitoba, 3) Manitoba women with distress which has continued from the postpartum period, and 4) Manitoba mothers who have never had significant distress. Information will be gathered through a previously tested web-based survey. Questions will address the influence of genetic knowledge on PPD and causes of asthma with respect to the concepts of normalcy, responsibility, and blame, and ascertain the best ways to communicate disease risk, so that women can realistically assess their child's risk of asthma and pursue a course of action that will be preventative.