Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Pediatric Gastroenterology, Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Int J Med Sci. 2024 Jul 8;21(9):1790-1798. doi: 10.7150/ijms.96326. eCollection 2024.
Atopic dermatitis (AD) is a chronic and relapsing dermatologic disease that can affect individuals of all ages, including children and adults. The prevalence of AD has increased dramatically over the past few decades. AD may affect children's daily activities, increase their parents' stress, and increase health expenditure. Constipation is a worldwide issue and may affect the gut microbiome. Some research has indicated that constipation might be associated with risk of atopic disease. The primary objective of this retrospective cohort study was to extend and to explore the link between maternal constipation and risk of atopic dermatitis in offspring. Using the Longitudinal Health Insurance Database, a subset of Taiwan's National Health Insurance Research Database, we identified 138,553 mothers with constipation and 138,553 matched controls between 2005 and 2016. Propensity score analysis was used matching birth year, child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and antibiotics usage, with a ratio of 1:1. Multiple Cox regression and subgroup analyses were used to estimate the adjusted hazard ratio of child AD. The incidence of childhood AD was 66.17 per 1,000 person-years in constipated mothers. By adjusting child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and received antibiotics, it was found that in children whose mother had constipation, there was a 1.26-fold risk of AD compared to the children of mothers without constipation (adjusted hazard ratio [aHR]: 1.26; 95% CI, 1.25-1.28). According to subgroup analyses, children in the maternal constipation group had a higher likelihood of AD irrespective of child's sex, birth weight, gestational weeks, mode of delivery, and with or without comorbidities, as well as usage of antibiotics during pregnancy. Compared to the non-constipated mothers, the aHR for the constipated mothers with laxative prescriptions <12 and ≥12 times within one year before the index date were 1.26; 95% CI, 1.24 -1.28 and 1.40; 95% CI, 1.29-1.52, respectively. Maternal constipation was associated with an elevated risk of AD in offspring. Clinicians should be aware of the potential link to atopic dermatitis in the children of constipation in pregnant women and should treat gut patency issues during pregnancy. More study is needed to investigate the mechanisms of maternal constipation and atopic diseases in offspring.
特应性皮炎（AD）是一种慢性复发性皮肤病，可影响所有年龄段的人，包括儿童和成人。在过去的几十年中，AD 的患病率急剧上升。AD 可能会影响儿童的日常活动，增加父母的压力，并增加医疗支出。便秘是一个全球性问题，可能会影响肠道微生物组。一些研究表明，便秘可能与特应性疾病的风险有关。本回顾性队列研究的主要目的是扩展并探索母亲便秘与后代特应性皮炎风险之间的联系。
我们使用台湾全民健康保险研究数据库的一个子集——纵向健康保险数据库，在 2005 年至 2016 年间确定了 138553 名患有便秘的母亲和 138553 名匹配对照者。采用倾向评分分析匹配出生年份、儿童性别、出生体重、妊娠周数、分娩方式、母亲合并症和抗生素使用情况，比例为 1:1。采用多 Cox 回归和亚组分析来估计儿童 AD 的调整后危险比。在患有便秘的母亲中，儿童 AD 的发生率为每 1000 人年 66.17 例。通过调整儿童的性别、出生体重、妊娠周数、分娩方式、母亲合并症和接受的抗生素，与没有便秘的母亲的孩子相比，母亲患有便秘的孩子患 AD 的风险增加了 1.26 倍（调整后危险比[aHR]：1.26；95%置信区间[CI]：1.25-1.28）。根据亚组分析，无论儿童的性别、出生体重、妊娠周数、分娩方式以及是否存在合并症，以及母亲在怀孕期间是否使用抗生素，患有便秘的儿童患 AD 的可能性均较高。与非便秘母亲相比，便秘母亲在索引日期前一年中泻药处方<12 次和≥12 次的调整后危险比（aHR）分别为 1.26；95%CI，1.24-1.28 和 1.40；95%CI，1.29-1.52。
母亲便秘与后代患 AD 的风险增加有关。临床医生应该意识到孕妇便秘与儿童特应性皮炎之间的潜在联系，并应在怀孕期间治疗肠道通畅问题。需要进一步研究以探讨母亲便秘和后代特应性疾病的发病机制。
