Return to Contents in this Issue

Original Article


Stress-Related Maternal Factors During Pregnancy in Relation to Childhood Eczema: Results From the LISA Study


S Sausenthaler,1 P Rzehak,1,2 CM Chen,1,3 P Arck,4,5 A Bockelbrink,6 T Schäfer,7 B Schaaf,8 M Borte,9,10 O Herbarth,11,12 U Krämer,13 A von Berg,14 HE Wichmann,1,2 J Heinrich1 for the LISA Study Groupa

1 Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
2 Ludwig-Maximilians University Munich, Institute of Medical Data Management, Biometrics and Epidemiology, Chair of Epidemiology, Munich, Germany
3 Ludwig-Maximilians-University of Munich, Dr. von Hauner Children’s Hospital, Munich, Germany
4 McMaster University, The Brain-Body Institute, Department of Medicine, Hamilton, Ontario, Canada
5 Centre of Internal Medicine and Dermatology, Division of Psycho-Neuro-Immunology, Charité, University Medicine Berlin, Germany
6 Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center Berlin, Germany
7 Department of Social Medicine, Medical University Lübeck, Germany
8 Medical Practice for Pediatrics, Bahnhofstrasse 6, 53604 Bad Honnef, Germany
9 University of Leipzig, Department of Pediatrics, Leipzig, Germany
10 Municipal Hospital “St. Georg” Leipzig, Children’s Hospital, Leipzig, Germany
11 UFZ – Center for Environmental Research, Department of Human Exposure Research and Epidemiology, Leipzig, Germany
12 University of Leipzig, Faculty of Medicine, Environmental Hygiene and Environmental Medicine, Leipzig, Germany
13 IUF- Institut für Umweltmedizinische Forschung, University of Düsseldorf, Germany
14 Marien-Hospital Wesel, Department of Pediatrics, Wesel, Germany
a The members of and institutions affi liated with the LISA study group are listed in the appendix (see full text PDF)

J Investig Allergol Clin Immunol 2009; Vol. 19(6): 481-487



Background: Stress has been suggested to impact the onset and exacerbation of eczema and other atopic disorders. Whether early exposure to stress-related factors might exert long-term effects remains to be clarified.

Objective: The objective of this study was to investigate whether stress-related maternal factors during pregnancy are associated with childhood eczema during the first 6 years of life.

Methods: Data from 3004 children from a prospective German birth cohort study (LISA) were analyzed. Information from maternity certificates and questionnaire information on unwanted pregnancy were used to evaluate stress-related maternal factors during pregnancy. Prevalence data for physician-diagnosed eczema were available up to the age of 6 years.

Results: Maternal factors during pregnancy were positively associated with childhood eczema in terms of cumulative prevalence up to the age of 2 years (adjusted odds ratio, 1.48; 95% confidence interval, 0.95-2.30) after adjusting for potential confounders. Beyond the second year no increased risk was observed.

Conclusions: The results of this study suggest that stress-related maternal factors during pregnancy are associated with an increased risk of childhood eczema during the first 2 years of life. The impact of postnatal stress such as parental divorce or separation on this association could not be clarified. Future studies should therefore further elucidate how prenatal and postnatal stress interact and whether prenatal stress might have a programming effect. If future studies confirm the findings of this study, reducing maternal stress during pregnancy might be a possible target in the primary prevention of eczema during childhood.

Key words: Stress-related maternal factors. Pregnancy. Eczema. LISA study. Birth cohort. Infants.