Interactions of Parents’ Stress and Environmental Factors on Children’s Eczema: Key Roles in Allergens and Air Pollution

Increasing evidence linked air pollution and social stress with eczema independently, yet their interactive effects on childhood eczema in early life are unknown. This study aimed to explore the effects of parental stresses and their interactions with interior and extraventricular environmental exposures on preschooler’s physician-diagnosed eczema (PDE). We conducted a mixed cross-sectional and retrospective cohort study involving 8689 children at Changsha in China. Individual data for health information, parental stresses, and interior environments were collected through questionnaires. Individual exposure to temperatures and extraventricular pollutants were computed using the Inverse Distance Weighted (IDW) technique method. Multivariable logistic regression analyses were engaged in this research. We found that childhood PDM PDE was markedly associated with higher education among parents (ORs [95% CI] = 1.94 [1.63–2.31]), while presence of fatigue, headache and distractibility amplified PDE risk (1.89 [1.64–2.18], 1.55 [1.39–1.74] and 1.63 [1.46–1.82]). Higher score of parental psychological stresses was related to elevated risks of PDE. Parents owning lower education or income had higher childhood PDE risk of moldy clothing/bedclothes, nonflowering plants, decoration throughout pregnancy till previous year. PDE risk from PM2.5, NO2 and O3 exposure mainly before birth were higher in families with high social stress. PDE risk from early life exposure to PM2.5, PM2.5–10, PM10, and NO2 during preconception, first year, and entire postnatal stage was higher in parents with psychological stress. Our study indicates that early life exposures to parental stresses as well as their combinations with interior and outdoor pollution and allergen increased risk of childhood PDE, suggesting the “(pre-)fetal origin of eczema” hypothesis through stress-environment interaction.