Prenatal Maternal Distress and Allergic Diseases in Offspring: Review of Evidence and Possible Pathways

Abstract

Recent studies have suggested a close association between prenatal maternal distress and allergic diseases in the offspring. We selected relevant birth-cohort or national registry studies using a keyword search of the PubMed database and summarized current evidence on the impact of prenatal maternal distress on the development of offspring's allergic diseases. Moreover, we postulated possible pathways linking prenatal distress and allergic diseases based on relevant human and animal studies. Both dysregulated hypothalamic-pituitary-adrenal axis and increased oxidative stress may cause structural (altered brain/lung development) and functional (skewed immune development) changes, which may predispose the fetus to developing allergic diseases during childhood. Although many facts are yet to be discovered, changes in the placental response and epigenetic modification are presumed to mediate the whole process from maternal distress to allergic diseases. Maternal prenatal distress can also interact with other physical or environmental factors, including familial or physical factors, indoor and outdoor pollutants, and early childhood psychological distress. The gut-microbiome-brain axis and the role of the microbiome as an immune modulator should be considered when investigating the stress-allergy relationship and exploring potential intervention modalities. Further research is needed, and particular attention should be given to defining the most vulnerable subjects and critical time periods. To this end, studies exploring relevant biomarkers are warranted, which can enable us to explore adequate intervention strategies.

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 .…”

“…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.…”

Maternal psychological distress during pregnancy and childhood health outcomes: a narrative review

“…Excessive oxidative stress exposure during human pregnancy has been associated with spontaneous abortion, IUGR, preterm delivery and allergic diseases in the offspring. 147,[196][197][198][199] Evidence, especially in humans, for the involvement of serotonin and tryptophan in the maternalfetal stress transfer is limited. Animal studies, however, provide preliminary evidence of a potential role for serotonin and tryptophan in fetal programming.…”

Prenatal Maternal Stress and the Risk of Asthma in Children

“…The existing evidence supports that a fraction of the maternal glucocorticoids cross the placenta, deregulates the hypothalamic–pituitary–adrenocortical (HPA) axis of the fetus, and augments the fetal glucocorticoid production ( 41 ). In turn, elevated glucocorticoids of the fetus may lead to a predominance of Th-2 response ( 44 ). It is also known that epigenetic pathways contribute to the regulation of immune development ( 45 ).…”