Maternal Stressful Life Events during Pregnancy and Atopic Dermatitis in Children Aged Approximately 4-6 Years.

Camilla C Senter,Oluwatobiloba A Akingbade,Kaja Z Lewinn,W Alex Mason,Christine T Loftus,Kecia N Carroll,Sheela Sathyanarayana,Annette L Fitzpatrick,Adam A Szpiro,Catherine J Karr,Nicole R Bush

doi:10.3390/ijerph18189696

Abstract

The prevalence of atopic dermatitis (AD) in children has steadily increased over time, yet it remains largely unknown how maternal factors during pregnancy are associated with child AD. Few studies have specifically assessed the relationship between prenatal stress and child AD, with inconsistent findings. In this prospective cohort study following 426 mother-child dyads from pregnancy to middle childhood, women reported stressful life events (SLEs) experienced during the 12 months before delivery and AD outcomes in children aged approximately 4–6 years, including current, location-specific, and ever AD. We used Poisson regression to estimate risk ratios (RRs) and corresponding 95% confidence intervals (CIs) associated with a 1-unit increase in prenatal SLEs, adjusting for potential confounders. We also assessed whether the association between prenatal SLEs and child AD was modified by child sex, history of maternal atopy, or prenatal maternal resilient coping. The mean (standard deviation) of prenatal SLEs reported in the overall sample was 1.4 (1.6), with 37.1% of women reporting none. A 1-unit increase in prenatal SLEs was not significantly associated with current AD (RR: 1.08, 95% CI: 0.89, 1.31), location-specific AD (RR: 1.09, 95% CI: 0.78, 1.52), or ever AD (RR: 0.97, 95% CI: 0.87, 1.09). We did not find evidence of effect modification. Findings from this study suggest no association between prenatal SLEs and AD in middle childhood, although larger longitudinal studies with enhanced case definition and higher variability of SLE experience may more fully inform this question.

Highlights

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by itchy rash, red blistering lesions, and sensitive dry skin
Current atopic dermatitis (AD) was defined as positive responses to ISAAC questionnaire items, “has your child ever had an itchy rash which was coming and going for at least 6 months?” and “has your child had this itchy rash at any time in the past 12 months?” Location-specific AD, considered a more specific characterization than current AD, was defined as having current AD and answering affirmatively to the question, “has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears or eyes?” we considered a secondary outcome of ever AD to be a positive response to the question, “has your child ever had eczema?”
Based on main model estimates, we found that a 1-unit increase in reported prenatal stressful life event (SLE) was not significantly associated with current AD