Do Children Born to Older Mothers Have Higher Eczema Risk?

In pregnancy, a mother is considered older (also known as advanced maternal age) at an age when she is beyond her “prime years” of reproduction, which is typically between 18-35 years old. Although there is no strict medical definition of advanced maternal age, it is typically defined as age 35 years or older. Advanced maternal age can be associated with higher risk for infertility, higher health risks for both the mother and baby during pregnancy and labor, and higher genetic abnormalities in the baby.[1,2] 

According to data from the Center for Disease Control and Prevention, the average age for first time mothers in the U.S. has increased from 24.9 years in 2000 to 26.3 years in 2014.[3] The major reasons for this trend of delaying pregnancy include the pursuit for higher education, career goals, and socioeconomic status. Additionally, the increasing availability and efficacy of birth control methods may have also led to increased age of first time mothers. Interestingly, in the recent decades, we are seeing a higher rate of atopic dermatitis that seems to coincide with having children at an older age.[4] One may then ask, are children born to older mothers more likely to develop eczema? 

Studies Looking at Mother’s Age When Giving Birth

There has been very little research conducted to look at this relationship. A group of researchers interviewed over 500 families that had more than 2 children.[4] They found that the second-born child is significantly more likely to have eczema than the first-born child. The average age of the mothers was 25 years old at the time of birth of the first child and 28 years when giving birth to the second child.[4] Based on these results, it is possible that the mothers’ higher age at the time of birth of their second child could be associated with the increased risk for eczema. The mechanism by which increased maternal age may be associated with increased eczema in the second born child needs further investigation. Socioeconomic status is known to play a role in the prevalence of eczema, and may be a factor in increased atopic dermatitis risk in subsequent children in a growing family due to higher financial demands. 

In another epidemiology study done in the United Kingdom in 1970 involving over 12,000 children, researchers concluded that maternal age is not an influencing factor for the children’s risk of developing atopic dermatitis.[5] In other words, the jury is still out on whether the “older mother theory” is linked to childhood eczema. 

Other Maternal Factors Associated with Eczema in Offspring

There is an ongoing and fervent search for significant factors that play a role in the onset and exacerbation of eczema, including research on various maternal factors. A recently published review article summarizes studies in the scientific literature that have looked at the role of the following factors in risk for eczema in offspring: 

  • Genetics: Increased risk for eczema if mothers are genetic carriers of the FLG gene mutation.[6] Maternal heritability of eczema also demonstrated through other genetic variations, including mitochondrial inheritance and polymorphisms.[7,8]
  • Immune System: Maternal immune response is associated with development of eczema in offspring.[6,9-11]
  • Nutrition: Higher maternal vegetable intake associated with decreased odds of offspring that develop eczema.[12]
  • Probiotics: Prenatal intake of probiotics may reduce the risk of eczema in children.[13,14]
  • Breastfeeding: Conflicting evidence in various studies to show whether breastfeeding is protective or not against eczema; this area of research remains controversial.[15,16]
  • Smoking: Tobacco smoking during pregnancy may increase the risk for eczema in children 2.3 times.[17]
  • Alcohol: Alcohol consumption during pregnancy increases risk for offspring to develop eczema.[18]
  • Maternal Contraceptive hormones: One study showed an increased risk for eczema in offspring in mothers who had previously used maternal contraceptive hormones prior to pregnancy.[19]
  • Occupational stress: Mothers working outside of the home during pregnancy showed increased risk for AD in offspring.[20]
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References

  1. Vannuccini S, Clifton VL, Fraser IS, et al. Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome. Hum Reprod Update.2016;22(1):104-115; PMID: 26395640 http://www.ncbi.nlm.nih.gov/pubmed/26395640.
  2. Sauer MV. Reproduction at an advanced maternal age and maternal health. Fertil Steril.2015;103(5):1136-1143; PMID: 25934599 http://www.ncbi.nlm.nih.gov/pubmed/25934599.
  3. T.J. Mathews aBEH. Mean Age of Mothers is on the Rise: United States, 2000–2014. 2016. Accessed September 5, 2016.
  4. Olesen AB, Ellingsen AR, Larsen FS, et al. Atopic dermatitis may be linked to whether a child is first- or second-born and/or the age of the mother. Acta Derm Venereol.1996;76(6):457-460; PMID: 8982411 http://www.ncbi.nlm.nih.gov/pubmed/8982411.
  5. Golding J, Peters TJ. The epidemiology of childhood eczema: I. A population based study of associations. Paediatr Perinat Epidemiol.1987;1(1):67-79; PMID: 3506192 http://www.ncbi.nlm.nih.gov/pubmed/3506192.
  6. Esparza-Gordillo J, Matanovic A, Marenholz I, et al. Maternal filaggrin mutations increase the risk of atopic dermatitis in children: an effect independent of mutation inheritance. PLoS Genet.2015;11(3):e1005076; PMID: 25757221 http://www.ncbi.nlm.nih.gov/pubmed/25757221.
  7. Raby BA, Klanderman B, Murphy A, et al. A common mitochondrial haplogroup is associated with elevated total serum IgE levels. J Allergy Clin Immunol.2007;120(2):351-358; PMID: 17666217
  8. Walley AJ, Chavanas S, Moffatt MF, et al. Gene polymorphism in Netherton and common atopic disease. Nat Genet.2001;29(2):175-178; PMID: 11544479 http://www.ncbi.nlm.nih.gov/pubmed/11544479.
  9. Hinz D, Bauer M, Roder S, et al. Cord blood Tregs with stable FOXP3 expression are influenced by prenatal environment and associated with atopic dermatitis at the age of one year. Allergy.2012;67(3):380-389; PMID: 22187950 http://www.ncbi.nlm.nih.gov/pubmed/22187950.
  10. Herberth G, Hinz D, Roder S, et al. Maternal immune status in pregnancy is related to offspring's immune responses and atopy risk. Allergy.2011;66(8):1065-1074; PMID: 21443636 http://www.ncbi.nlm.nih.gov/pubmed/21443636.
  11. Fu Y, Lou H, Wang C, et al. T cell subsets in cord blood are influenced by maternal allergy and associated with atopic dermatitis. Pediatr Allergy Immunol.2013;24(2):178-186; PMID: 23506292 http://www.ncbi.nlm.nih.gov/pubmed/23506292.
  12. Beckhaus AA, Garcia-Marcos L, Forno E, et al. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis. Allergy.2015;70(12):1588-1604; PMID: 26296633 http://www.ncbi.nlm.nih.gov/pubmed/26296633.
  13. Pelucchi C, Chatenoud L, Turati F, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology.2012;23(3):402-414; PMID: 22441545 http://www.ncbi.nlm.nih.gov/pubmed/22441545.
  14. Rautava S, Kainonen E, Salminen S, et al. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol.2012;130(6):1355-1360; PMID: 23083673 http://www.ncbi.nlm.nih.gov/pubmed/23083673.
  15. Dattner AM. Breastfeeding and atopic dermatitis: protective or harmful? facts and controversies. Clin Dermatol.2010;28(1):34-37; PMID: 20082948 http://www.ncbi.nlm.nih.gov/pubmed/20082948.
  16. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev.2012;10.1002/14651858.CD000133.pub3(9):CD000133; PMID: 22972039 http://www.ncbi.nlm.nih.gov/pubmed/22972039.
  17. Schafer T, Dirschedl P, Kunz B, et al. Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring. J Am Acad Dermatol.1997;36(4):550-556; PMID: 9092740 http://www.ncbi.nlm.nih.gov/pubmed/9092740.
  18. Wada K, Konishi K, Tamura T, et al. Alcohol Intake During Pregnancy and Offspring's Atopic Eczema Risk. Alcohol Clin Exp Res.2016;40(5):1037-1043; PMID: 27062380 http://www.ncbi.nlm.nih.gov/pubmed/27062380.
  19. Frye C, Mueller JE, Niedermeier K, et al. Maternal oral contraceptive use and atopic diseases in the offspring. Allergy.2003;58(3):229-232; PMID: 12653797
  20. Wang IJ, Wen HJ, Chiang TL, et al. Maternal employment and atopic dermatitis in children: a prospective cohort study. Br J Dermatol.2013;168(4):794-801; PMID: 23528059 http://www.ncbi.nlm.nih.gov/pubmed/23528059.