title: Prenatal maternal distress affects atopic dermatitis in offspring mediated by oxidative stress.
abstract: Recent 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.
  
  
  
  We investigated whether prenatal maternal distress is associated with AD risk in offspring and whether the mechanism is mediated by reactive oxygen species.
  
  
  
  Two 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.
  
  
  
  In 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).
  
  
  
  Prenatal 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.
authors.affiliation: 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.
authors.forename: Hyoung Yoon
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong In
authors.initials: DI
authors.lastname: Suh
authors.affiliation: Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Song-I
authors.initials: SI
authors.lastname: Yang
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Mi-Jin
authors.initials: MJ
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Environmental Health Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.affiliation: Sewon Infant Child Development Center, Seoul, Korea.
authors.forename: In Ae
authors.initials: IA
authors.lastname: Choi
authors.affiliation: Department of Rehabilitation, Hanshin University, Osan, Korea.
authors.forename: Kyung-Sook
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yee-Jin
authors.initials: YJ
authors.lastname: Shin
authors.affiliation: Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Shin
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kangmo
authors.initials: K
authors.lastname: Ahn
authors.affiliation: Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hye-Sung
authors.initials: HS
authors.lastname: Won
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Suk-Joo
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Kwon
authors.affiliation: Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Han
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
authors.forename: Kyung-Ju
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Jun
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ho-Sung
authors.initials: HS
authors.lastname: Yu
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seung-Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Bok Kyoung
authors.initials: BK
authors.lastname: Jung
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Korea Institute of Child Care and Education, Seoul, Korea.
authors.forename: Yoon Kyung
authors.initials: YK
authors.lastname: Choi
authors.affiliation: Korea Institute of Child Care and Education, Seoul, Korea.
authors.forename: Namhee
authors.initials: N
authors.lastname: Do
authors.affiliation: Korea Institute of Child Care and Education, Seoul, Korea.
authors.forename: Yun Jin
authors.initials: YJ
authors.lastname: Bae
authors.affiliation: Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Ho
authors.initials: H
authors.lastname: Kim
authors.affiliation: Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Science, Korea National Institute of Health, Cheongju, Korea.
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Chang
authors.affiliation: Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Science, Korea National Institute of Health, Cheongju, Korea.
authors.forename: Eun-Jin
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Science, Korea National Institute of Health, Cheongju, Korea.
authors.forename: Jeom Kyu
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea; Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Environmental Health Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: sjhong@amc.seoul.kr.
authors.forename: Soo-Jong
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D015415:Biomarkers; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D008875:Middle Aged; D016017:Odds Ratio; D018384:Oxidative Stress; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D016016:Proportional Hazards Models; D012307:Risk Factors; D013312:Stress, Physiological; D013315:Stress, Psychological; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Anxiety; atopic dermatitis; cohort; depression; prenatal; psychological stress; reactive oxygen species