One meta-analysis found an association between maternal alcohol consumption and atopic dermatitis in offspring.[1] Interestingly, it didn’t find an association between alcohol consumption and the skin condition for adults. It should be noted that these observations are based on a relatively small amount of research. It is possible that alcohol exposure in utero can lead to an immune system imbalance — called Th2 dominance — that is more associated with atopic dermatitis, but there may be other reasons.
There is some evidence that being born in winter or fall is associated with a greater prevalence of atopic dermatitis.[2] One probable reason for this is lower humidity and an increased risk of skin dryness and disrupted skin barrier function during the first months of life. Higher immune activity during winter has also been observed, which could increase the likelihood of excessive skin inflammation. Vitamin D levels are a plausible cause, but the evidence for this scenario specifically isn’t compelling.[3][4]
A meta-analysis found that a mother taking probiotic mixtures during pregnancy or breastfeeding can reduce the risk of atopic dermatitis in her children.[5] This provides evidence that the maternal gut microbiome during pregnancy is relevant to offspring, though evidence outside of the context of probiotic supplementation is lacking. Another meta-analysis, investigating the effects of Lactobacillus and Bifidobacterium bacteria mixtures in children, also found convincing evidence for a reduction in risk.[6] However, it should be noted that almost all studies included supplementation during pregnancy; only two studies didn’t. Yet another study looked at any probiotic supplementation and found notable benefits when women took probiotics during pregnancy. A total of 5 studies looked only at supplementation for infants; the results were positive overall, but we can’t be sure of them, and more research is needed.[7] The evidence for giving infants and children probiotics for prevention is promising but very preliminary.
Early-life antibiotic use is associated with a higher risk of atopic dermatitis, though this could be as a result of an increased risk of infections due to other factors that further increase the risk of the skin condition.[8]
Being overweight or gaining a large amount of weight during pregnancy is associated with a higher risk of atopic dermatitis in children, while low weight gain during pregnancy is associated with a lower risk.[9] These risks are small, and the extent to which the weight gain itself — rather than confounding factors, such as stress — plays a role is unclear.
Preliminary evidence suggests that maternal stress, anxiety, and adverse life events that could be causes of stress and anxiety are associated with a greater risk of atopic dermatitis in their children.[10]
There is also some evidence that prenatal phthalate exposure increases the risk. [11]
The gut microbiome seems to be critical early in life to the risk for atopic dermatitis. Probiotic use during pregnancy and breastfeeding are likely protective, while antibiotic use is associated with a higher risk. Adverse prenatal conditions, such as excessive weight gain, stress and anxiety, or exposure to alcohol or phthalates, are also associated with an increased risk.
References
- ^A-S Halling-Overgaard, C R Hamann, R P Holm, A Linneberg, J I Silverberg, A Egeberg, J P ThyssenAtopic dermatitis and alcohol use - a meta-analysis and systematic reviewJ Eur Acad Dermatol Venereol.(2018 Aug)
- ^Monika Calov, Farzad Alinaghi, Carsten Robert Hamann, Jonathan Silverberg, Alexander Egeberg, Jacob Pontoppidan ThyssenThe Association Between Season of Birth and Atopic Dermatitis in the Northern Hemisphere: A Systematic Review and Meta-AnalysisJ Allergy Clin Immunol Pract.(2020 Feb)
- ^Bo L Chawes, Klaus Bønnelykke, Jakob Stokholm, Nadja H Vissing, Elín Bjarnadóttir, Ann-Marie M Schoos, Helene M Wolsk, Tine Marie Pedersen, Rebecca K Vinding, Sunna Thorsteinsdóttir, Lambang Arianto, Henrik W Hallas, Lene Heickendorff, Susanne Brix, Morten A Rasmussen, Hans BisgaardEffect of Vitamin D3 Supplementation During Pregnancy on Risk of Persistent Wheeze in the Offspring: A Randomized Clinical TrialJAMA.(2016 Jan 26)
- ^Debra J PalmerVitamin D and the Development of Atopic EczemaJ Clin Med.(2015 May 20)
- ^Nasya Amalia, David Orchard, Kate Louise Francis, Emma KingSystematic review and meta-analysis on the use of probiotic supplementation in pregnant mother, breastfeeding mother and infant for the prevention of atopic dermatitis in childrenAustralas J Dermatol.(2020 May)
- ^Minghui Sun, Jing Luo, Hanmei Liu, Yue Xi, Qian LinCan Mixed Strains of Lactobacillus and Bifidobacterium Reduce Eczema in Infants under Three Years of Age? A Meta-AnalysisNutrients.(2021 Apr 25)
- ^Shuya Sun, Guizhen Chang, Litao ZhangThe prevention effect of probiotics against eczema in children: an update systematic review and meta-analysisJ Dermatolog Treat.(2021 May 18)
- ^T Tsakok, T M McKeever, L Yeo, C FlohrDoes early life exposure to antibiotics increase the risk of eczema? A systematic reviewBr J Dermatol.(2013 Nov)
- ^Wenshu Chen, Lei Wang, Hao Yao, Huan Dai, Rongying Zheng, Weixi ZhangPrepregnancy BMI, gestational weight gain and risk of childhood atopic dermatitis: A systematic review and meta-analysisPediatr Allergy Immunol.(2021 Jul)
- ^Carmen W H Chan, Bernard M H Law, Yun-Hong Liu, Alexandra R B Ambrocio, Natasha Au, Melody Jiang, Ka Ming ChowThe Association between Maternal Stress and Childhood Eczema: A Systematic ReviewInt J Environ Res Public Health.(2018 Feb 25)
- ^Minyoung Jung, Min-Ji Kim, Seonwoo Kim, Yechan Kyung, Minji Kim, Ji Young Lee, Hye-In Jeong, Bo Ra Lee, Jihyun Kim, Kangmo Ahn, Yong Mean ParkEffect of prenatal phthalate exposure on childhood atopic dermatitis: A systematic review and meta-analysisAllergy Asthma Proc.(2021 Jul 1)