Quality of mothers’ care in early life linked to atopic dermatitis in infants

Until recently, little was known about the association between the mother-child relationship early in life and the development of atopic dermatitis (AD), a childhood skin disease that is often the first step in the “atopic march” toward allergic rhinitis and ultimately asthma.

Now, new research led by Dr. Nicole Letourneau, a researcher within AllerGen’s Gene-Environment Interactions Enabling Platform, has shown that low maternal sensitivity increases the risk for AD, which may contribute to the development of childhood asthma later on.

“Maternal sensitivity refers to a mother’s ability to interpret and respond to her infant’s needs based on behavioural signals, such as crying and fussing, or other cues that indicate need,” says Dr. Letourneau, a University of Calgary nursing professor and the Alberta Children’s Hospital Foundation Chair in Parent-Infant Mental Health.

“Based on observations of mothers with their infants during a typical play session, we found that almost 25% of infants developed AD by 18 months of age when their mothers exhibited low sensitivity compared to less than 1% of infants developing AD when their mothers were highly sensitive.”

Similarly, the researchers found that 20% to 25% of children had AD when their mothers were very unresponsive or controlling—concepts that are contrary to sensitivity—during play.

The research was published in the May 2017 issue of Allergy, Asthma and Clinical Immunology. AllerGen investigator Dr. Anita Kozyrskyj and AllerGen trainee Nela Cosic are study co-authors.

Dr. Letourneau’s team examined data from 242 women and their children involved in the Alberta Pregnancy Outcomes and Nutrition (APrON) birth cohort. The researchers used observational videos to evaluate the quality of the mother-infant interactions at six months of age and assessed the presence of AD in the babies at 18 months, based on mothers’ reports of physician diagnosis.

“We also examined other factors known to contribute to AD, such as maternal asthma status, depression, anxiety and stress,” adds Dr. Letourneau. “We found that the association between the maternal-infant relationship and AD is independent of these other factors, which tells us how important a mother’s interactions with her baby are.”

The study’s findings are consistent with earlier evidence linking maternal-infant relationship quality and child allergic disease, according to Dr. Letourneau.

“Our results suggest that interventions that improve the quality of this relationship can reduce the risk of AD and possibly forestall the development of childhood asthma.”