Maternal sensitivity and social support protect against childhood atopic dermatitis

Abstract

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.

Exploring the association between parental psychiatric disease and childhood atopic dermatitis: a matched case–control study

“…15 Similarly, no significant associations were found between maternal anxiety and AD development in their offspring. While most studies addressing this relationship have found significant associations, 14,15,20 some have reported mixed results. 19,21 These associations are even more commonly reported when the definition of anxiety is broadened to include stress/work stress, 12,16,18,40,46,47 or stressful life events.…”

“…For example, maternal inflammatory bowel disease was protective against AD development risk in Israeli children, while prenatal exposure to chemical haptens and air pollutants has been associated with increased AD in the offspring. [9][10][11] Maternal stress during pregnancy and a history of psychiatric disease have been identified as possible risk factors for AD development in the offspring, [12][13][14][15][16][17][18] although these findings are not universal. [19][20][21][22][23] Notably, method of AD ascertainment and selection of controls differ across these studies, with some studies utilizing standardized symptom-based questionnaires, 12,13,[15][16][17]20 while others used self-reported physician-diagnosed eczema, 12,13,20 or AD, 14 and others relied on physical examination and clinical AD criteria.…”

Does Prenatal Anxiety or Depression Symptoms Associate With Asthma or Atopic Diseases Throughout the Offspring's Childhood? An Updated Systematic Review and Meta-analysis

“…Of these, 273 articles were left for full-text screening and 264 were excluded because of not accessible (n=10), study aim/design (n=54), population (n=100), outcome (n=28), intervention (n=63), animal (n=9). Since no additional records identi ed through other sources, giving a total of 9 observational studies entered our nal model [10,12,13,[18][19][20][21][22][23].…”

“…Characteristics of the included studies Table 1 presents the included studies [10,12,13,[18][19][20][21][22][23]. There were 4 prospective cohort studies [7,[18][19][20], 4 retrospective cohort studies [12,13,21,22] [11,13,21,22] and 1 case-control study [23]. The majority of included studies came from Europe, and the rest of them were from America.…”

“…The included studies investigated based on different exposure including depression, anxiety, depression or anxiety, mental health service use, prenatal postpartum distress, and negative life events. Studies were grouped into the categories according to their outcomes which had 5 asthma [10,12,13,18,21], 3 AD [19,20,23], and 1 asthma and AD [22]. To ensure the reliability and quality control of this metaanalysis, we scored each of the included studies by using NOS criteria, studies with more than ve stars can be included in the research.…”