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Kawaguchi C, Ozawa M, Hidaka T, Murakami K, Ishikuro M, Ueno F, Noda A, Onuma T, Shinoda G, Orui M, Obara T, Ito Y, Kakinuma T, Kudoh K, Ozawa H, Nakagawa S, Mizuashi M, Omori R, Deguchi M, Kanbayashi Y, Asano M, Takahashi T, Tanita M, Hara M, Yamasaki K, Tadaki T, Suzuki H, Kikuchi K, Tsuchiyama K, Ohashi T, Sasai S, Honda M, Fujimura T, Furudate S, Kagimoto Y, Kawamura M, Tabata N, Chikama R, Komatsu H, Sato Y, Tanita K, Kimura Y, Yusa S, Terui H, Tono H, Muto Y, Kuriyama S, Yamamoto M, Aiba S. Skin health survey on atopic dermatitis among Japanese children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Allergol Int 2025; 74:246-253. [PMID: 39426877 DOI: 10.1016/j.alit.2024.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 09/14/2024] [Accepted: 09/25/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Precise skin phenotypic data are indispensable in accurately diagnosing atopic dermatitis (AD). Therefore, this study examined the interobserver concordance for AD and non-AD diagnoses between two dermatologists. AD prevalence determined by the self-reported physician diagnoses and the diagnoses determined from the United Kingdom (UK) diagnostic criteria were compared with the diagnoses made by the two dermatologists, using data from a skin health survey. METHODS This study included 1,638 children that participated in the skin health survey, which was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. AD was assessed using dermatologist assessments, self-reported physician diagnoses, and the UK diagnostic criteria. The concordance for diagnoses was evaluated using kappa. The sensitivity and specificity of the self-reported physician diagnoses and the UK diagnostic criteria were calculated by comparing them with the two dermatologists' diagnoses. RESULTS Among the 1,638 children, 393 (24.0 %), 194 (11.9 %), and 597 (37.2 %) were diagnosed with AD by the two dermatologists, physicians, and the UK diagnostic criteria, respectively. The kappa (95 % CI) of the interobserver concordance for AD or non-AD diagnoses between the two dermatologists was 0.78 (0.75-0.81). The sensitivity and specificity of the self-reported physician diagnoses were 26.7 % and 94.1 %, respectively. The sensitivity and specificity of the UK diagnostic criteria were 85.0 % and 82.4 %, respectively. CONCLUSIONS Interobserver concordance for AD or non-AD diagnoses between the two dermatologists was substantial. Self-reported physician diagnoses exhibited low sensitivity that potentially indicated underdiagnosis of AD, whereas the UK diagnostic criteria might overdiagnose AD.
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Affiliation(s)
- Chikana Kawaguchi
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Maki Ozawa
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Toshoguekimae Dermatology Clinic, Miyagi, Japan
| | - Takanori Hidaka
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan.
| | - Mami Ishikuro
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Aoi Noda
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, Miyagi, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Genki Shinoda
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Masatsugu Orui
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Taku Obara
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, Miyagi, Japan
| | - Yumiko Ito
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | | | - Kazuhiro Kudoh
- Division of Dermatology, Katta General Hospital, Miyagi, Japan
| | | | | | - Masato Mizuashi
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Rifu Dermatology Allergy Clinic, Miyagi, Japan
| | - Ryoko Omori
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | | | - Yumi Kanbayashi
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Masayuki Asano
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Nanohana Dermatology Clinic, Iwate, Japan
| | - Toshiya Takahashi
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Muneo Tanita
- Department of Dermatology, Tohoku Rosai Hospital, Miyagi, Japan
| | | | - Kenshi Yamasaki
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | | | - Hiromi Suzuki
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Arai Ekimae Suzuki Clinic, Miyagi, Japan
| | - Katsuko Kikuchi
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Sendai Taihaku Dermatology Clinic, Miyagi, Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Natori Tsuchiyama Dermatology Clinic, Miyagi, Japan
| | | | - Shu Sasai
- Asuto-Nagamachi Dermatologic Clinic, Miyagi, Japan
| | - Motoko Honda
- Ichibancho Minami Shinryoujo Akane Clinic, Miyagi, Japan
| | - Taku Fujimura
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Sadanori Furudate
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Division of Dermatology, Osaki Citizen Hospital, Miyagi, Japan
| | | | | | - Nobuko Tabata
- Division of Dermatology, Japanese Red Cross Sendai Hospital, Miyagi, Japan
| | | | | | - Yota Sato
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Division of Dermatology, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan
| | - Kayo Tanita
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Yutaka Kimura
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Kimura Dermatology Clinic, Miyagi, Japan
| | - Shino Yusa
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tagajo Ekimae Hifuka, Miyagi, Japan
| | - Hitoshi Terui
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hisayuki Tono
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Nanohana Dermatology Clinic, Iwate, Japan
| | - Yusuke Muto
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Department of Dermatology, South Miyagi Medical Centre, Miyagi, Japan
| | - Shinichi Kuriyama
- Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan; Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Miyagi, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Setsuya Aiba
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Matsuda Hospital, Miyagi, Japan
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Kawaguchi C, Murakami K, Ishikuro M, Ueno F, Noda A, Onuma T, Matsuzaki F, Metoki H, Kuriyama S, Obara T. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth 2022; 22:242. [PMID: 35331140 PMCID: PMC8944031 DOI: 10.1186/s12884-022-04556-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/25/2022] [Indexed: 12/20/2022] Open
Abstract
Background Maternal mental health problems in each of the prenatal period and postnatal period have been demonstrated as possible risk factors for atopic dermatitis (AD) in children. However, the cumulative impacts of maternal psychological distress in the prenatal and postnatal periods on AD in children remain unclear. This study examined the association between cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and the development of AD in children. Methods Data were derived from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. In total, 8377 mother-child pairs in which the child had no AD at the age of 1 year were analyzed. Maternal psychological distress in early pregnancy and 1 year after delivery was defined as a K6 score ≥ 5, and the participants were categorized into four groups: no psychological distress in both the prenatal and postnatal periods; only the prenatal period; only the postnatal period; and both periods. The development of AD was defined as the presence of AD in a 2-year-old child without AD reported at the age of 1 year using the International Study of Asthma and Allergies in Childhood questionnaire. Generalized linear model analyses were conducted to examine the association between maternal psychological distress and the development of AD in children adjusted for age at delivery, educational attainment, smoking status in pregnancy, maternal history of AD, paternal history of AD, parity, maternal body mass index, and child sex. Results Between the ages of 1 and 2 years, 14.0% of children developed AD. Maternal psychological distress in both prenatal and postnatal periods was associated with an increased risk of AD in children compared to no psychological distress in both periods (relative risk (RR), 95% confidence interval (CI): 1.34, 1.20–1.47). Maternal psychological distress in only the postnatal period was associated with an increased risk of AD in children (RR, 95% CI: 1.23, 1.07–1.39), but not in only the prenatal period (RR, 95% CI: 1.14, 0.98–1.30). Conclusions Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods was associated with the development of AD in children. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04556-8.
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Affiliation(s)
- Chikana Kawaguchi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Keiko Murakami
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. .,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Fumihiko Ueno
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Aoi Noda
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Fumiko Matsuzaki
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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