Maternal type 1 diabetes linked to offspring atopic dermatitis risk

The risk of offspring atopic dermatitis (AD) risk is significantly increased by maternal type 1 diabetes mellitus (T1DM), according to a recent study published in JAAD International.¹

Up to 30% of children are impacted by AD, severely affecting their quality of life through sleep disturbance, itch, anxiety, and depression.² Connections between AD and maternal factors such as gestational diabetes, exposure to stress, antibiotics, and smoking have been investigated.¹

“To our knowledge no study has investigated the impact of maternal [T1DM] on early childhood development of AD,” wrote investigators.

Assessing AD prevalence

The retrospective cohort study was conducted to evaluate the association between maternal T1DM and AD prevalence in offspring. Data was obtained from the Clalit Health Services data sharing platform, which extracts information from electronic medical records.

Live singleton births from January 1, 2010, to December 31, 2023, were included in the analysis, with follow-up data available through 2024. Mothers were enrolled in Clalit Health Services, a health maintenance organization.

International Classification of Diseases, Tenth Revision codes were used to identify T1DM cases before delivery. These codes were also used to identify AD in offspring, which was reported as the primary outcome.

Investigators included diagnoses made during hospitalization and outpatient visits. Covariates included maternal age, ethnicity, parity, gestational age, mode of delivery, and socioeconomic status (SES). Maternal AD, allergic rhinitis, and smoking status were also reported, alongside child sex and follow-up duration.

Participant characteristics and AD risk

There were 311,708 mother-child pairs included in the analysis, of whom 0.35% of children were born to mothers with T1DM. These mothers had a mean age of 31.8 years vs 30.1 years in those without T1DM. Parity was 1.39 and 1.66, respectively, and the odds of delivering preterm were 22% vs 5.6%, respectively.

T1DM mothers were also more likely to delivery by cesarean section and to be in a medium socioeconomic group. Allergic rhinitis, AD, and other atopic states did not significantly differ between groups.

The odds of AD were significantly increased in offspring of mothers with T1DM, with a rate of 29% vs 26% in those of mothers without T1DM. Median ages at diagnosis did not significantly differ between groups, at 1.28 vs 1.27 years, respectively.

Impacts of hemoglobin A1C and lingering association

Associations were not reported for a maternal hemoglobin A1C greater than 6.5% with AD rates, at 29% vs 28% for hemoglobin A1C of 6.5% or less. However, the age at diagnosis was slightly greater in the former group vs the latter, at 1.30 vs 1.12 years, respectively.

After adjusting for covariates, an association remained between maternal T1DM and offspring AD risk, with an odds ratio of 1.15. However, a hazard ratio of 1.10 was reported for the impact on time to diagnosis, indicating no significant association.

Overall, the data indicated an independent association between maternal T1DM and increased offspring AD risk. Investigators concluded maternal metabolic and immune function may influence early-life atopic conditions.

“Future studies should explore underlying mechanisms, including the role of autoimmunity, chronic inflammation, and epigenetic modifications, and should evaluate whether better glycemic control before and during pregnancy could mitigate this risk,” wrote investigators.

References

1. Weissmann S, Amitai N, Honig E, Eshkoli T, Horev A. Maternal type 1 diabetes mellitus and atopic dermatitis in offspring: a nationwide cohort study. JAAD Int. Published online March 30, 2026. doi:10.1016/j.jdin.2026.03.013
2. Fasseeh AN, Elezbawy B, Korra N, et al. Burden of atopic dermatitis in adults and adolescents: a systematic literature review. Dermatol Ther (Heidelb). 2022(12):2653-2668. doi:10.1007/s13555-022-00819-6