• Hyoung Yoon Chang, Dong In Suh, Song-I Yang, Mi-Jin Kang, So-Yeon Lee, Eun Lee, In Ae Choi, Kyung-Sook Lee, Yee-Jin Shin, Youn Ho Shin, Yoon Hee Kim, Kyung Won Kim, Kangmo Ahn, Hye-Sung Won, Suk-Joo Choi, Soo-Young Oh, Ja-Young Kwon, Young Han Kim, Hee Jin Park, Kyung-Ju Lee, Jong Kwan Jun, Ho-Sung Yu, Seung-Hwa Lee, Bok Kyoung Jung, Ji-Won Kwon, Yoon Kyung Choi, Namhee Do, Yun Jin Bae, Ho Kim, Woo-Sung Chang, Eun-Jin Kim, Jeom Kyu Lee, and Soo-Jong Hong.
• Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea; Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Korea; Center for Traumatic Stress, Ajou University Medical Center, Suwon, Korea.
• J. Allergy Clin. Immunol. 2016 Aug 1; 138 (2): 468-475.e5.

BackgroundRecent evidence suggests that prenatal maternal distress increases the risk of allergic diseases in offspring. However, the effect of prenatal maternal depression and anxiety on atopic dermatitis (AD) risk remains poorly understood.ObjectiveWe investigated whether prenatal maternal distress is associated with AD risk in offspring and whether the mechanism is mediated by reactive oxygen species.MethodsTwo general population-based birth cohorts formed the study. One cohort (Cohort for Childhood Origin of Asthma and Allergic Diseases [COCOA]) consisted of 973 mother-baby dyads, and the other (Panel Study on Korean Children [PSKC]) consisted of 1531 mother-baby dyads. The association between prenatal distress and AD was assessed by using Cox proportional hazards and logistic regression models. In COCOA placental 11β-hydroxysteroid dehydrogenase type 2 and glutathione levels and serum IgE levels in 1-year-old children were measured.ResultsIn COCOA and PSKC AD occurred in 30.6% (lifetime prevalence) and 11.6% (1 year prevalence) of offspring, respectively. Prenatal maternal distress increased the risk of AD in offspring, both in COCOA (hazard ratio for depression, 1.31 [95% CI, 1.02-1.69]; hazard ratio for anxiety, 1.41 [95% CI, 1.06-1.89]) and PSKC (odds ratio for distress, 1.85 [95% CI, 1.06-3.25]). In COCOA both prenatal maternal depression and anxiety scores were positively related to the predicted probability of AD (P < .001 in both). Prenatal distress decreased placental glutathione to glutathione disulfide ratios (P = .037) and, especially in those who later had AD, decreased placental 11β-hydroxysteroid dehydrogenase type 2 levels (P = .010) and increased IgE levels at 1 year of age (P = .005).ConclusionPrenatal maternal depression and anxiety promote risk of AD in offspring. Maternal distress increases the predicted probability of AD. The mechanism might involve chronic stress, abnormal steroid levels, and reactive oxygen species.Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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