BackgroundA growing number of studies suggest that maternal stress during pregnancy promotes atopic disorders in the offspring. This is the first systematic review to address prenatal maternal stress (PNMS) and the subsequent risk of atopy‐related outcomes in the child.MethodsThe review was performed in accordance to the PRISMA criteria. We searched and selected studies in PubMed, Scopus, Embase and PsychINFO until November 2014.ResultsSixteen (with 25 analyses) of 426 identified articles met the review criteria. Five main PNMS exposures (negative life events, anxiety/depression, bereavement, distress and job strain) and five main atopic outcomes (asthma, wheeze, atopic dermatitis, allergic rhinitis and IgE) were assessed across the studies. Overall, 21 of the 25 analyses suggested a positive association between PNMS and atopic outcomes. Of the 11 exposure–response analyses reported, six found statistically significant trends.ConclusionThis systematic review suggests a relationship between maternal stress during pregnancy and atopic disorders in the child. However, the existing studies are of diverse quality. The wide definitions of often self‐reported stress exposures imply a substantial risk for information bias and false‐positive results. Research comparing objective and subjective measures of PNMS exposure as well as objective measures for atopic outcome is needed.

Findings suggest the presence of depression may confer an increased risk of infection and that this increased susceptibility is not confined to a specific time period following the onset of depression. A dose-response relationship may be present, but more research is needed to further examine and confirm a link between depression and risk of infection.