Additive effect between prenatal depression and transepidermal water loss on atopic dermatitis via Th2 immune responses: COCOA study
Monday, March 5, 2018
South Hall A2 (Convention Center)
Mi-young Lee, Dr.So-Yeon Lee, Si Hyeon Lee, Ji-Sun Yoon, Sungsu Jung, Hyun-ju Cho, MD, Dong In Suh, Youn Ho Shin, Kyung Won Kim, Kangmo Ahn, MD, PhD, Kyung-Sook Lee, Yee-Jin Shin, Soo-Jong Hong
RATIONALE: stress during pregnancy and a defect in skin barrier function may influence childhood allergic diseases, potentially through effects on immune development.

To test the hypothesis that maternal depression during pregnancy and skin barrier dysfunction are associated the development of atopic dermatitis (AD) in infancy through immune responses.

METHODS: Study subjects consisted of 1,716 mother-baby pairs from the longitudinal Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) birth cohort study. Prenatal stress scales were evaluated using self-reported questionnaires by Center for Epidemiologic Studies Depression (CESD) on 36th weeks of pregnancy. AD in children was diagnosed by pediatric allergists at 1 year. Serum IgE and transepidermal water loss (TEWL) at 1 year and cord blood cytokine assay were measured.

RESULTS: Prenatal maternal depression was not associated with the risk of TEWL and AD at 1 year. High TEWL increased the risk of AD at 1 year (aOR 1.896, 95% CI 1.034-3.479). When divided into four groups using CESD and TEWL, high CESD and high TEWL showed a significant positive association with AD (aOR 5.487, 95% CI 1.572-19.148). Infants with high CESD and high TEWL had the highest ratio of IL-13 / IFN-γ in cord blood and serum IgE at 1 year among 4 groups.

CONCLUSIONS: This study showed an additive effect of CESD and skin barrier dysfunction for increasing risk for the development of AD through Th2 immune response in early life.