임신 중 PM2.5 노출과 산모의 불안이 유아 아토피피부염에 미치는 영향: COCOA study

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease and mostly occurred in infants. AD in children is increasing not only in the world but also in Korea. Although the cause of AD has not clearly identified, genetic factors and environmental factors are related to the development of AD. Objective: The aim of this study was to investigate the effect of Particulate Matter 2.5 (PM2.5) and prenatal anxiety on AD in infant and identify the critical risk period. Methods: The present study population was a subset of children recruited COhort for Childhood Origin of Asthma and allergic diseases (COCOA) birth cohort study. This study included 802 children who followed-up at 1 year of age and having all data used in this analysis. PM2.5 was estimated by land-use regression models, and prenatal anxiety was measured by questionnaire. AD was diagnosed by pediatric allergy specialists at 1 year. Logistic regression analysis was used to calculate odd ratio (OR) and 95% confidence interval (CI) and Bayesian distributed lag interaction model was used to identify the critical period. Results: Higher PM2.5 exposure during the first trimester of pregnancy (aOR, 1.86

95% CI, 1.08-3.19

) and higher prenatal maternal anxiety (aOR, 1.58

95% CI, 1.01-2.47

) was associated with AD at 1 year old. Infants with both higher PM2.5 during first trimester of pregnancy and higher maternal anxiety during pregnancy increased AD at 1 year old (aOR, 3.13

95% CI, 1.56-6.28

). Higher PM2.5 exposure during first trimester of pregnancy increased the risk of AD at 1 year old only in boys (aOR, 2.33

95% CI, 1.10-4.96). In the boys exposed to higher maternal anxiety during pregnancy, exposure to PM2.5 at 5 - 8 weeks of pregnancy is the most critical period for the development of 1-year-old AD. Conclusion: Higher PM2.5 exposure and maternal anxiety during pregnancy increased the risk of AD at 1 year. Boys exposed to both higher PM2.5 during 5 - 8 weeks of gestation and maternal anxiety during pregnancy had a significantly increased risk for AD at 1 year old. Avoidance of exposure to PM2.5 and maternal anxiety during prenatal period, especially in the first trimester, may prevent the development of infantile AD especially in boys.