Maternal psychiatric symptoms during pregnancy and risk of childhood atopic diseases

Abstract

SummaryBackground Maternal psychiatric symptoms during pregnancy might affect the developing immune system and subsequent risk of childhood atopic diseases. Objective Our aim was to examine the associations of maternal psychiatric symptoms during pregnancy with allergic sensitization, allergy and eczema in children until age 10 years. Methods This study among 5205 children was performed in a population-based prospective cohort from foetal life onwards. We assessed maternal and paternal psychiatric symptoms (overall, depressive, anxiety) during pregnancy and at 36 months after delivery, and maternal psychiatric symptoms at 2 and 6 months after delivery using the Brief Symptom Inventory. Inhalant and food allergic sensitization were measured by skin prick tests, and physician-diagnosed inhalant and food allergy or eczema by questionnaires from birth until age 10 years. We used multivariate logistic regression, multinomial logistic regression or generalized estimating equation models where appropriate. Results We observed no association of maternal psychiatric symptoms during pregnancy with allergic sensitization. Maternal overall psychiatric, depressive and anxiety symptoms during pregnancy were associated with an increased risk of inhalant allergy only (adjusted odds ratio (95% confidence interval) 1.96 (1.44, 2.65), 1.58 (1.25, 1.98) and 1.61 (1.27, 2.03), respectively, per 1-unit increase). Maternal overall psychiatric and anxiety symptoms during pregnancy were associated with an increased risk of eczema (1.21 (1.05, 1.39) and 1.15 (1.02, 1.29), respectively, per 1-unit increase). Effect estimates did not materially change when maternal psychiatric symptoms after delivery, or paternal psychiatric symptoms during pregnancy and after delivery were taken into account. Conclusions and Clinical Relevance Maternal psychiatric symptoms during pregnancy were associated with increased risks of childhood inhalant allergy and eczema, independent of maternal psychiatric symptoms after delivery and of paternal psychiatric symptoms.

Nut allergy guideline

“…Perceived, preconception stress was significantly associated with offspring eczema at age 12 months but not at 6 months (see front cover of this issue of the journal). This chimes with data published earlier this year linking maternal psychiatric disease during pregnancy with offspring eczema [6].…”

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

“…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 .…”

EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma

“…Allergen intake has been used as a marker for diet diversity . The study found no consistent association between timing and diversity of allergenic solid food introduction and allergic sensitization, physician‐diagnosed food allergy or eczema up to 10 y of age.…”