The impact of childhood stressful life events on atopic dermatitis disease activity and severity.

Atopic dermatitis (AD) is a prevalent condition that has been associated with stress, but epidemiologic data on the impact of both common and severe childhood stressors are limited. Our objective was to evaluate the impact of stressful life events throughout early childhood on AD activity and severity. We conducted a longitudinal cohort study of 13,972 children ages 1 to 8.5 years from the Avon Longitudinal Study of Parents and Children. Responses to a standardized stressful life events scale were linked to repeated measures of AD annual period prevalence and severity. After adjusting for potential confounders, we found that for each standard deviation increase in stressful life events, there was a small increased risk of concurrent AD activity (OR 1.04, 95% CI 1.01-1.07), which was higher for moderate-to-severe AD (OR 1.13, 95% CI 1.03-1.23), and for a cumulative measure of stressful events across childhood (OR 1.11, 95% CI 1.07-1.16). The association was driven by common stressful life events like starting a new school or having a new baby sibling that were perceived as impactful to individual children more than severe adverse childhood events like being separated from a parent or abused. These results may help to provide anticipatory guidance to families.