MATERNAL SMOKING DURING PREGNANCY AND LACTATION INCREASES THE RISK FOR ATOPIC ECZEMA IN THE OFFSPRING

Background: Maternal smoking during pregnancy has been shown to lead t o immunologic changes in the offspring, However, little is known about the influence of this exposure on atopic manifestations. Objective: O ur purpose was to investigate the influence of air pollutants on manif estations of atopy in preschool children. Methods: Unselected cohorts of a total of 678 5- to 6-year-old preschool children (350 boys, 328 g irls) were investigated in areas with different degrees of air polluti on in Bavaria. Data on the history of atopic diseases and other releva nt factors were obtained by questionnaire. A skin-prick test was perfo rmed with common aeroallergens. Manifestation of atopy was defined as personal history of atopic disease or positive prick test to either gr ass pollen, house dust mite, or cat and analyzed multivariately. Resul ts: Of all children, 38.9% exhibited at least one manifestation of ato py. Atopic eczema was reported in 7.9% to 15.5%, hayfever in 4.1% to 2 5.6%, and asthma in 3.0% to 8.1%. Of the mothers, 12.6% smoked during pregnancy or lactation or both. Analysis of the manifestation of atopy including sex, location, nitrogen oxide and sulfur dioxide exposure a nd maternal smoking as covariates revealed an influence of the materna l smoking during pregnancy/lactation, Of children whose mothers had sm oked during pregnancy/lactation, 52.2% exhibited manifestations of ato py in contrast to 35.7% of children of nonsmoking mothers (p < 0.044), A history of atopic eczema was the only component of the variable ''m anifestation of atopy'' that was significantly associated with materna l smoking during pregnancy and lactation. A causal interpretation of t his finding, however, was not supported by a follow-up study. Conclusi on: Maternal smoking during pregnancy or lactation or both might play a role in the development of atopic eczema and should be avoided.