title: Maternal prenatal stress and child atopic dermatitis up to age 2 years: The Ulm SPATZ health study.
abstract: Evidence linking maternal psychosocial stress during pregnancy to subsequent child atopic dermatitis (AD) is growing, but the definition of AD is diverse and results are inconsistent. We aimed to analyze the relationship between stress and AD using alternative measurements of stress and AD.
  
  
  
  In the Ulm SPATZ Health Study, chronic stress and symptoms of anxiety and depression were assessed by standardized self-reported questionnaires in 934 mothers of singletons following delivery in Ulm, Germany, from 04/2012-05/2013. Maternal hair cortisol concentrations (HCCs, n = 626) at childbirth and the cumulative incidences of parent-reported child AD symptoms, parent-, and pediatrician-reported AD diagnoses were assessed until age 2 years (n = 787). Overall, 205 dermatologic examinations were performed in 167 children showing AD symptoms. Crude and adjusted risk ratios (RR, aRR) with 95% confidence intervals were estimated.
  
  
  
  Maternal stress and anxiety were associated with child AD symptoms by trend (RR and aRR: 1.5 (1.0,2.3) for the highest vs. the lowest quarter of chronic stress; aRR: 1.4 (1.0,2.0) for possible anxiety symptoms vs. no symptoms). No relationship was found between stress or related constructs and AD diagnoses nor could we show consistent associations between maternal HCC and child AD. However, a higher RR of child AD was evident in families not yet affected by AD in siblings given maternal depressive symptoms, examined in the crude model.
  
  
  
  Stress measurements or related constructs are linked to AD symptoms, but association with AD diagnoses is limited. The reason for this divergence still needs further research.
authors: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors: Stefanie
authors: S
authors: Braig
authors: Department of Dermatology and Allergic Diseases, University of Ulm, Ulm, Germany.
authors: Johannes M
authors: JM
authors: Weiss
authors: Department of Psychology, TU Dresden, Dresden, Germany.|Clinical Psychology, University of Siegen, Siegen, Germany.
authors: Tobias
authors: T
authors: Stalder
authors: Department of Psychology, TU Dresden, Dresden, Germany.
authors: Clemens
authors: C
authors: Kirschbaum
authors: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors: Dietrich
authors: D
authors: Rothenbacher
authors: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors: Jon
authors: 0000-0001-5764-1528
authors: J
authors: Genuneit
mesh_terms: D001007:Anxiety; D002675:Child, Preschool; D003863:Depression; D003876:Dermatitis, Atopic / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012306:Risk; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: atopic dermatitis; birth cohort; prenatal; psychosocial stress; symptoms of anxiety and depression