Maternal psychologic problems increased the risk of childhood atopic dermatitis

Wang, I. J.; Wen, H. Joseph; Chiang, Tung Liang; Lin, Shio‐Jean; Guo, Yang

doi:10.1111/pai.12518

Cited by 33 publications

(46 citation statements)

References 25 publications

(27 reference statements)

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“…A trend for an inverse association between postnatal depression and AD was also observed. These findings are compatible with several studies on childhood atopic disease associations with maternal prenatal or postnatal stressors [13, 16–18, 59, 103], prenatal anxiety but not depression, as suggested above [88, 104–107]. Mutual adjustment for anxiety and depression may have uncovered the negative influence of postnatal depression on the health care utilization for infant care and thus, physician diagnosis of AD [108].…”

Section: Discussionsupporting

confidence: 90%

“…Infants whose caregivers are less sensitive have higher levels of cortisol [33, 88] and excess cortisol exposure during early infancy may influence the developing immune response via epigenetics or neuroendocrine dysregulation, potentially leading to AD [87, 89, 90]. It is also possible that more sensitive mothers take greater care of their infants’ skin, by for example, use of moisturizer and regular bathing; however, how this may contribute to the atopic march toward asthma is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…As maternal anxiety becomes more prevalent [109], it may gain a more prominent influence on the maternal–infant relationship [97]. Given that low maternal sensitivity and anxiety are interrelated, the association with childhood AD may be similarly mediated by epigenetics or neuroendocrine dysregulation [88, 104, 110], and altered infant cytokine profiles [111]. Infant neuroendocrine and immunologic maturation is highly plastic in the face of environmental stressors [112–115], especially during the early postnatal period.…”

Section: Discussionmentioning

confidence: 99%

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Maternal sensitivity and social support protect against childhood atopic dermatitis

Létourneau

Kozyrskyj

Cosic

et al. 2017

Allergy Asthma Clin Immunol

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BackgroundMany studies have identified associations between qualities of maternal–child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal–infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors.MethodsWe conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age.ResultsHigher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD.ConclusionsLow maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal–infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Maternal sensitivity and social support protect against childhood atopic dermatitis

Létourneau

Kozyrskyj

Cosic

et al. 2017

Allergy Asthma Clin Immunol

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“…Interestingly, some studies have indicated that maternal stress during pregnancy may play a significant role in the development of AD in offspring. It is possible that in cases where pregnant women suffer not only from AD but also from depression or psychosomatic disorders, the offspring have a significantly higher risk of developing AD up to the age of 18–20 years . Possible psycho‐immunological pathways are changes in cytokine levels or oxidative stress transferred by the placenta .…”

Section: Factors That May Explain Change In Atopic Dermatitis Severitmentioning

confidence: 99%

“…It is possible that in cases where pregnant women suffer not only from AD but also from depression or psychosomatic disorders, the offspring have a significantly higher risk of developing AD up to the age of 18-20 years. [27][28][29][30][31][32][33][34] Possible psycho-immunological pathways are changes in cytokine levels 21 or oxidative stress transferred by the placenta. 35 Psychosocial job strain in general and alcohol intake during pregnancy in particular 36,37 are significant risk factors for AD development in offspring, with alcohol intake being the most prominent risk factor.…”

Section: Factors That May Explain Change In Atopic Dermatitis Severitmentioning

confidence: 99%

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Vestergaard

Wollenberg

Barbarot

et al. 2019

Acad Dermatol Venereol

173

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Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults, including a large number of adults of reproductive age. Several guidelines for the treatment of AD exist, yet specific recommendations for the treatment of pregnant or lactating women and for adults planning to have a child are often lacking. This position paper from the European Task force on Atopic Dermatitis (ETFAD) is based on up‐to‐date scientific literature on treating pregnant and lactating women as wells as adults with AD planning to have a child. It is based on the expert opinions of members of the ETFAD and on existing safety data on the proposed treatments, many of which are derived from patients with other inflammatory diseases or from transplantation medicine. For treating future parents, as well as pregnant and lactating women with AD, the use of topical treatments including moisturizers, topical corticosteroids, tacrolimus, antiseptics such as chlorhexidine, octenidine, potassium permanganate and sodium hypochlorite (bleach) is deemed to be safe. Ultraviolet (UV) therapy may also be used. Systemic treatment should be prescribed only after careful consideration. According to the opinion of the ETFAD, treatment should be restricted to systemic corticosteroids and cyclosporine A, and, in selected cases, azathioprine.

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Early exposure to maternal stress and risk for atopic dermatitis in children: A systematic review and meta‐analysis

Ai,

Huang,

Zhu

2024

Clinical & Translational All

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BackgroundThe incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.Methods and findingsA comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case‐control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random‐effects model. Twenty‐two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13–1.47), maternal anxiety (OR 1.31, 95% CI: 1.18–1.46), and negative life events (OR 2.00, 95% CI: 1.46–2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09–1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.ConclusionsEarly maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.

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Maternal psychologic problems increased the risk of childhood atopic dermatitis

Abstract: Postpartum depression increased the risk of childhood AD even when other maternal mental health index and social demographic factors are considered. Early intervention of PPD might be helpful for AD prevention.

Cited by 33 publications

References 25 publications

Maternal sensitivity and social support protect against childhood atopic dermatitis

Maternal sensitivity and social support protect against childhood atopic dermatitis

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Early exposure to maternal stress and risk for atopic dermatitis in children: A systematic review and meta‐analysis

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