January 28, 2019

Positive but weak associations were found between childhood atopic dermatitis and maternal history of depression, maternal alcohol abuse, and maternal illicit drug use.

Positive but weak associations were found between childhood atopic dermatitis (AD) and maternal depression, alcohol abuse, and illicit drug use, according to the results of a large, nationwide, case-control study conducted in Denmark and published in the Journal of the European Academy of Dermatology and Venereology.

The investigators sought to quantify the relationships between maternal and paternal psychiatric disease and the development of AD in children via use of nationwide health and social registries in Denmark. All Danish children who were born between January 1, 1996, and December 31, 2011, who developed AD prior to 5 years of age were identified and matched in a 1:10 ratio with control subjects from the general Danish population and with children receiving care in a similar ambulatory/hospital setting.

A total of 8602 pediatric patients with AD were matched with control subjects. Rates of parental psychiatric care were similar among those in the AD arm and those in the control arm. Compared with individuals in the general population, weak associations were reported among childhood AD and the following factors: (1) maternal history of depression or  depressive symptoms (odds ratio [OR] 1.18; 95% CI, 1.12-1.26; P <.0001); (2) maternal history of alcohol abuse (OR 1.37; 95% CI, 1.17-1.60; P <.0001); and (3) maternal history of illicit drug use (OR 1.34; 95% CI, 1.14-1.60; P =.0005). However, when the pediatric ambulatory/hospital group was used as the control arm, the associations were no longer significant: (1) OR 1.05; 95% CI, 0.99-1.13; (2) OR 1.14; 95% CI, 0.98-1.34; and (3) OR 1.03; 95% CI, 0.88-1.22, respectively.

Furthermore, no paternal psychiatric disease or prenatal maternal psychiatric disease was shown to be associated with the development of AD among the offspring evaluated.

The investigators concluded that the children of parents with substance abuse issues may be more inclined to receive a diagnosis of AD. A major strength of this study is that 2 separate control populations were used as comparators. A weakness of the current study is that it was limited to children who developed AD prior to 5 years of age, as well as to those who sought care at university- and hospital-based clinics. Moreover, based on the study design, causality cannot be determined.

Disclosure: Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.

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Reference

Hamann CR, Egeberg A, Silverberg JI, Gislason G, Skov L, Thyssen JP. Exploring the association between parental psychiatric disease and childhood atopic dermatitis: a matched case-control study [published online November 1, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15321