Prenatal Maternal Risk Factors Contributing to Atopic Dermatitis: A Systematic Review and Meta-analysis of cohort studies
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Background: The gestational risk factors predispose to the manifestation of early childhoodatopic dermatitis (AD). Objective: We evaluated the association between modifiable and non-modifiable gestationaland prenatal risk factors that affect the AD prevalence in children. Methods: We performed the systematic review and meta-analysis of cohort studies (n=27) inPubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effectsmodels to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematicreview according to Preferred Reporting Item for Systematic Review and Meta-Analyses(PRISMA) guidelines and summarized cohort studies investigating gestational and prenatalrisk factor those predispose to AD in off spring. Leading modifiable and non-modifiablewere identified through ORs. Meta-analysis using the random effect model was also conductedto provide an overall estimate for several significant factors. Results: Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval[CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history ofeczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestationof AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16),exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking duringpregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. Conclusion: Conclusively, both genetic and environmental factors play a pivotal role in earlymanifestation of AD. The better managing the environmental factors during gestationalphase to the least can help curtail the prevalence of AD in children.
Abstract
Background: The gestational risk factors predispose to the manifestation of early childhoodatopic dermatitis (AD). Objective: We evaluated the association between modifiable and non-modifiable gestationaland prenatal risk factors that affect the AD prevalence in children. Methods: We performed the systematic review and meta-analysis of cohort studies (n=27) inPubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effectsmodels to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematicreview according to Preferred Reporting Item for Systematic Review and Meta-Analyses(PRISMA) guidelines and summarized cohort studies investigating gestational and prenatalrisk factor those predispose to AD in off spring. Leading modifiable and non-modifiablewere identified through ORs. Meta-analysis using the random effect model was also conductedto provide an overall estimate for several significant factors. Results: Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval[CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history ofeczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestationof AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16),exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking duringpregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. Conclusion: Conclusively, both genetic and environmental factors play a pivotal role in earlymanifestation of AD. The better managing the environmental factors during gestationalphase to the least can help curtail the prevalence of AD in children.
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