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Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring
T Schäfer1, P Dirschedl, B Kunz
1Department of Dermatology, Technical University Munich, Germany.
Insights
Maternal smoking during pregnancy is linked to a higher risk of atopy in children. Specifically, children of mothers who smoked were more likely to develop atopic eczema.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Immunology
Background:
- Maternal smoking during pregnancy is known to cause immunologic changes in offspring.
- The impact of maternal smoking on atopic manifestations in children remains unclear.
Purpose of the Study:
- To investigate the influence of maternal smoking and air pollutants on atopic manifestations in preschool children.
- To analyze the association between maternal smoking during pregnancy/lactation and the development of atopy.
Main Methods:
- A cohort of 678 preschool children (ages 5-6) was studied in areas with varying air pollution levels.
- Data on atopic diseases and maternal smoking were collected via questionnaires.
- Skin-prick tests were performed, and atopy was defined by disease history or positive tests to common aeroallergens.
Main Results:
- 38.9% of children showed at least one manifestation of atopy.
- Children of mothers who smoked during pregnancy/lactation had a significantly higher rate of atopic manifestations (52.2%) compared to children of non-smoking mothers (35.7%).
- Atopic eczema was the only component of atopy significantly associated with maternal smoking, though causality was not confirmed by follow-up.
Conclusions:
- Maternal smoking during pregnancy or lactation may contribute to the development of atopic eczema in children.
- Avoiding maternal smoking during pregnancy and lactation is recommended to potentially reduce the risk of atopic eczema.
Background:
Maternal smoking during pregnancy has been shown to lead to immunologic changes in the offspring. However, little is known about the influence of this exposure on atopic manifestations.
Objective:
Our purpose was to investigate the influence of air pollutants on manifestations of atopy in preschool children.
Methods:
Unselected cohorts of a total of 678 5- to 6-year-old preschool children (350 boys, 328 girls) were investigated in areas with different degrees of air pollution in Bavaria. Data on the history of atopic diseases and other relevant factors were obtained by questionnaire. A skin-prick test was performed with common aeroallergens. Manifestation of atopy was defined as personal history of atopic disease or positive prick test to either grass pollen, house dust mite, or cat and analyzed multivariately.
Results:
Of all children, 38.9% exhibited at least one manifestation of atopy. Atopic eczema was reported in 7.9% to 15.5%, hayfever in 4.1% to 25.6%, and asthma in 3.0% to 8.1%. Of the mothers, 12.6% smoked during pregnancy or lactation or both. Analysis of the manifestation of atopy including sex, location, nitrogen oxide and sulfur dioxide exposure and maternal smoking as covariates revealed an influence of the maternal smoking during pregnancy/lactation. Of children whose mothers had smoked during pregnancy/lactation, 52.2% exhibited manifestations of atopy in contrast to 35.7% of children of nonsmoking mothers (p < 0.044). A history of atopic eczema was the only component of the variable "manifestation of atopy" that was significantly associated with maternal smoking during pregnancy and lactation. A causal interpretation of this finding, however, was not supported by a follow-up study.
Conclusion:
Maternal smoking during pregnancy or lactation or both might play a role in the development of atopic eczema and should be avoided.