Offspring of mothers with alopecia areata at greater risk for related conditions

Key takeaways:

• Newborns of mothers with alopecia areata were twice as likely to develop the condition vs. controls.
• Subjects were more likely to experience vitiligo, atopic disorders, hypothyroidism and psychiatric disorders.

Newborns of mothers with alopecia areata experienced a significantly greater risk for developing alopecia and accompanying comorbidities, according to a study.

“Several studies have reported maternal autoimmunity and the development of autoimmune and inflammatory disorders in offspring, but studies on [alopecia areata (AA)] are rare,” Ju Yeong Lee, MD, of the department of dermatology at Yonsei University Wonju College of Medicine in Wonju, Korea, and colleagues wrote. “Therefore, we constructed a nationwide birth cohort to determine whether the presence of maternal AA is associated with increased risk of comorbidities that have been reported to be associated with AA in offspring born to mothers with AA.”

The retrospective population-based birth cohort study, conducted using the Nationwide Health Insurance Service and its linked birth registration database in Korea, included 67,364 newborns (51.8% boys) born between 2003 and 2015 to 46,352 mothers with AA and 673,630 controls born to 454,085 mothers without AA.

The maternal age of mothers with AA was reportedly higher than healthy controls (31.2 vs. 30.9 years; P < .001). Additionally, newborns of mothers with AA were more likely to be delivered via cesarean section compared with controls (41.2% vs. 38.4%; P < .001).

After adjusting for age, insurance type, income level, location of residence, mode of delivery and maternal history of other disorders, hazard ratios showed that the risk for developing AA was significantly higher in newborns of mothers with AA compared with newborns of mothers without AA (adjusted HR = 2.08; 95% CI, 1.88-2.3).

Similarly, the risks for alopecia totalis/universalis (AT/AU) were also elevated in this population (aHR = 1.57; 95% CI, 1.18-2.08), especially when born to mothers specifically diagnosed with AT/AU (aHR = 2.98; 95% CI, 1.48-6).

Many comorbidities were also associated with maternal AA including vitiligo (aHR = 1.47; 95% CI, 1.32-1.63), atopic disorders (aHR = 1.07; 95% CI, 1.06-1.09) and hypothyroidism (aHR = 1.14; 95% CI, 1.03-1.25).

Newborns of mothers with AA also had a high risk for developing psychiatric disorders (aHR = 1.15; 95% CI, 1.11-1.20), and newborns of mothers with AT/AU showed an even higher risk (aHR, 1.27; 95%CI, 1.12-1.44).

“Exposure to maternal AA was associated with increased risk of autoimmune, inflammatory, atopic, thyroid and psychiatric disorders in offspring,” the authors concluded. “Clinicians and mothers with AA need to be aware that their children might have these comorbidities, and clinicians should make an accurate diagnosis when they occur.”