Maternal Alopecia Areata and Associated Disorders in Offspring

A new study published in the JAMA suggests that maternal Alopecia Areata (AA) is associated with autoimmune, atopic, thyroid, and psychiatric disorders in offspring.

Alopecia areata (AA) is associated with diverse autoimmune and psychiatric disorders. However, an investigation on the long-term outcomes for offspring born to mothers diagnosed with AA is lacking.

A study was done to investigate the risks for autoimmune, inflammatory, atopic, thyroid, and psychiatric outcomes of offspring born to mothers with AA.

This retrospective population-based birth cohort study used the linked birth registration database with the Nationwide Health Insurance Service database of Korea. The participants included all newborns born to mothers with 3 or more visits with International Classification of Diseases, Tenth Revision code of L63 and 1:10 birth year, sex, insurance, income, and location of residence–matched control offspring born to mothers without AA during the years from 2003 to 2015. The analysis was conducted from July 2022 to January 2023.

The occurrence of the following diseases was measured in newborns from birth to December 31, 2020:

• Alopecia Areata (AA)
• Alopecia Totalis/Universalis (AT/AU)
• Vitiligo
• Psoriasis
• Inflammatory Bowel Disease
• Rheumatoid Arthritis
• Atopic Dermatitis
• Allergic Rhinitis
• Asthma
• Hyperthyroidism
• Hypothyroidism
• Graves Disease
• Hashimoto Thyroiditis
• Attention-Deficit Hyperactivity Disorder
• Mood Disorder
• Anxiety Disorder

Multivariable Cox proportional hazard analyses were performed with the following covariates: birth year, age, insurance type, income level, location of residence, maternal age, mode of delivery, maternal history of atopic disorders, and autoimmune disorders.

Results

In total, 67,364 offspring born to 46,352 mothers with AA and 673,640 controls born to 454,085 unaffected mothers were analyzed. The risk of AA, AT/AU, vitiligo, atopic disorders, hypothyroidism, and psychiatric disorders was significantly increased in offspring born to mothers with AA. Among them, 5,088 born to mothers with AT/AU were at much greater risk for the development of AT/AU and psychiatric disorders.

In this Korean retrospective population-based birth cohort study, maternal AA was associated with the development of autoimmune/inflammatory, atopic, thyroid, and psychiatric disorders in their offspring. Clinicians and parents need to be aware of the potential for these comorbidities to occur.

Reference

Lee JY, Ju HJ, Han JH, et al. Autoimmune, Inflammatory, Atopic, Thyroid, and Psychiatric Outcomes of Offspring Born to Mothers With Alopecia Areata. JAMA Dermatol. Published online May 24, 2023. doi:10.1001/jamadermatol.2023.1261