{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:11:16Z","timestamp":1791389476340,"version":"4.3.3"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec id=\"ab-doi230017-4\"><jats:title>Importance<\/jats:title><jats:p>Alopecia areata (AA) is associated with diverse autoimmune and psychiatric disorders. However, an investigation on the long-term outcomes for offspring born to mothers diagnosed with AA is lacking.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the risks for autoimmune, inflammatory, atopic, thyroid, and psychiatric outcomes of offspring born to mothers with AA.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective population-based birth cohort study used the linked birth registration database with the Nationwide Health Insurance Service database of Korea. The participants included all newborns born to mothers with 3 or more visits with <jats:italic>International Classification of Diseases<\/jats:italic>, <jats:italic>Tenth Revision<\/jats:italic> code of L63 and 1:10 birth year, sex, insurance, income, and location of residence\u2013matched control offspring born to mothers without AA during the years from 2003 to 2015. The analysis was conducted from July 2022 to January 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-7\"><jats:title>Exposure<\/jats:title><jats:p>Maternal AA.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The occurrence of the following diseases was measured in newborns from birth to December 31, 2020: AA, alopecia totalis\/universalis (AT\/AU), vitiligo, psoriasis, inflammatory bowel disease, rheumatoid arthritis, atopic dermatitis, allergic rhinitis, asthma, hyperthyroidism, hypothyroidism, Graves disease, Hashimoto thyroiditis, attention-deficit hyperactivity disorder, mood disorder, and anxiety disorder. Multivariable Cox proportional hazard analyses were performed with the following covariates: birth year, age, insurance type, income level, location of residence, maternal age, mode of delivery, maternal history of atopic disorders, and autoimmune disorders.<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-9\"><jats:title>Results<\/jats:title><jats:p>In total, 67\u202f364 offspring born to 46\u202f352 mothers with AA and 673\u202f640 controls born to 454\u202f085 unaffected mothers were analyzed. The risk of AA (adjusted hazard ratio [aHR], 2.08; 95% CI, 1.88-2.30), AT\/AU (aHR, 1.57; 95% CI, 1.18-2.08), vitiligo (aHR, 1.47; 95% CI, 1.32-1.63), atopic disorders (aHR, 1.07; 95% CI, 1.06-1.09), hypothyroidism (aHR, 1.14; 95% CI, 1.03-1.25), and psychiatric disorders (aHR, 1.15; 95% CI, 1.11-1.20) was significantly increased in offspring born to mothers with AA. Among them, 5088 born to mothers with AT\/AU were at much greater risk for the development of AT\/AU (aHR, 2.98; 95% CI, 1.48-6.00) and psychiatric disorders (aHR, 1.27; 95% CI, 1.12-1.44).<\/jats:p><\/jats:sec><jats:sec id=\"ab-doi230017-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this Korean retrospective population-based birth cohort study, maternal AA was associated with the development of autoimmune\/inflammatory, atopic, thyroid, and psychiatric disorders in their offspring. Clinicians and parents need to be aware of the potential for these comorbidities to occur.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.1261","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T15:33:30Z","timestamp":1684942410000},"page":"711","source":"Crossref","is-referenced-by-count":11,"title":["Autoimmune, Inflammatory, Atopic, Thyroid, and Psychiatric Outcomes of Offspring Born to Mothers With Alopecia Areata"],"prefix":"10.1001","volume":"159","author":[{"given":"Ju Yeong","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jeong","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Hee","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Seoul St Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Min","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solam","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"doi230017r1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jaad.2009.10.032","article-title":"Alopecia areata update: part I. clinical picture, histopathology, and pathogenesis.","volume":"62","author":"Alkhalifah","year":"2010","journal-title":"J Am Acad Dermatol"},{"key":"doi230017r2","doi-asserted-by":"publisher","first-page":"17011","DOI":"10.1038\/nrdp.2017.11","article-title":"Alopecia areata.","volume":"3","author":"Pratt","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"doi230017r3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.jaut.2018.12.001","article-title":"Alopecia areata: a multifactorial autoimmune condition.","volume":"98","author":"Simakou","year":"2019","journal-title":"J Autoimmun"},{"issue":"1","key":"doi230017r4","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1007\/s12016-017-8620-9","article-title":"Alopecia areata: a comprehensive review of pathogenesis and management.","volume":"54","author":"Tr\u00fceb","year":"2018","journal-title":"Clin Rev Allergy Immunol"},{"issue":"5","key":"doi230017r5","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1111\/bjd.16808","article-title":"Alopecia areata: a review of disease pathogenesis.","volume":"179","author":"Rajabi","year":"2018","journal-title":"Br J Dermatol"},{"issue":"2","key":"doi230017r6","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.jaad.2018.07.013","article-title":"Comorbidities in alopecia areata: a systematic review and meta-analysis.","volume":"80","author":"Lee","year":"2019","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"doi230017r7","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1111\/ced.v46.4","article-title":"Comorbidities of alopecia areata: a population-based cohort study.","volume":"46","author":"Egeberg","year":"2021","journal-title":"Clin Exp Dermatol"},{"issue":"5","key":"doi230017r8","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.jaad.2019.05.086","article-title":"Association between alopecia areata, anxiety, and depression: a systematic review and meta-analysis.","volume":"88","author":"Okhovat","year":"2019","journal-title":"J Am Acad Dermatol"},{"issue":"12","key":"doi230017r9","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1056\/NEJMra020100","article-title":"The effect of infections on susceptibility to autoimmune and allergic diseases.","volume":"347","author":"Bach","year":"2002","journal-title":"N Engl J Med"},{"issue":"3","key":"doi230017r10","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1007\/s13555-021-00512-0","article-title":"Patient perspectives of the social, emotional and functional impact of alopecia areata: a systematic literature review.","volume":"11","author":"Mostaghimi","year":"2021","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"5","key":"doi230017r11","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1046\/j.1365-2230.2002.01077.x","article-title":"Epidemiology and genetics of alopecia areata.","volume":"27","author":"McDonagh","year":"2002","journal-title":"Clin Exp Dermatol"},{"issue":"6","key":"doi230017r12","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1111\/jdv.2019.33.issue-6","article-title":"Association between parental autoimmune disease and atopic dermatitis in their offspring: a matched case-control study.","volume":"33","author":"Hamann","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"4","key":"doi230017r13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.7503","article-title":"Association of maternal autoimmune diseases with risk of mental disorders in offspring in Denmark.","volume":"5","author":"He","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"5","key":"doi230017r14","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.jaad.2020.10.063","article-title":"Familial risk and incidence of alopecia areata among first degree relatives-A nationwide population-based study in Korea.","volume":"85","author":"Kim","year":"2021","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"doi230017r15","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1111\/bjd.v185.2","article-title":"Association between atopic dermatitis and autoimmune diseases: a population-based case-control study.","volume":"185","author":"Ivert","year":"2021","journal-title":"Br J Dermatol"},{"issue":"2","key":"doi230017r16","doi-asserted-by":"publisher","DOI":"10.1111\/pai.v33.2","article-title":"Maternal autoimmune disease and risk of hospitalization for autoimmune disease, allergy, and cancer in offspring.","volume":"33","author":"Zhao","year":"2022","journal-title":"Pediatr Allergy Immunol"},{"issue":"2","key":"doi230017r17","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/S0923-1811(02)00015-4","article-title":"Antioxidant enzymes and lipid peroxidation in the scalp of patients with alopecia areata.","volume":"29","author":"Akar","year":"2002","journal-title":"J Dermatol Sci"},{"issue":"7302","key":"doi230017r18","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1038\/nature09114","article-title":"Genome-wide association study in alopecia areata implicates both innate and adaptive immunity.","volume":"466","author":"Petukhova","year":"2010","journal-title":"Nature"},{"issue":"1","key":"doi230017r19","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1038\/jidsymp.2013.20","article-title":"The national alopecia areata registry-update.","volume":"16","author":"Duvic","year":"2013","journal-title":"J Investig Dermatol Symp Proc"},{"key":"doi230017r20","doi-asserted-by":"publisher","first-page":"5966","DOI":"10.1038\/ncomms6966","article-title":"Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new susceptibility loci.","volume":"6","author":"Betz","year":"2015","journal-title":"Nat Commun"},{"issue":"1","key":"doi230017r21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.4104\/pcrj.2013.00108","article-title":"Transgenerational occurrence of allergic disease and autoimmunity: general practice-based epidemiological research.","volume":"23","author":"Maas","year":"2014","journal-title":"Prim Care Respir J"},{"issue":"1","key":"doi230017r22","first-page":"35","article-title":"DNA polymorphism of HLA class II genes in alopecia areata.","volume":"9","author":"Morling","year":"1991","journal-title":"Dis Markers"},{"issue":"6","key":"doi230017r23","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1111\/1523-1747.ep12412584","article-title":"Human leukocyte antigen-DQB1*03 alleles are associated with alopecia areata.","volume":"103","author":"Welsh","year":"1994","journal-title":"J Invest Dermatol"},{"issue":"3","key":"doi230017r24","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1111\/1523-1747.ep12395398","article-title":"Severity of alopecia areata is associated with a polymorphism in the interleukin-1 receptor antagonist gene.","volume":"103","author":"Tarlow","year":"1994","journal-title":"J Invest Dermatol"},{"issue":"2","key":"doi230017r25","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1046\/j.0022-202x.2001.01676.x","article-title":"Interleukin-1 receptor antagonist allele 2 and familial alopecia areata.","volume":"118","author":"Barahmani","year":"2002","journal-title":"J Invest Dermatol"},{"issue":"2","key":"doi230017r26","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1038\/s41580-020-00314-w","article-title":"Cellular senescence in ageing: from mechanisms to therapeutic opportunities.","volume":"22","author":"Di Micco","year":"2021","journal-title":"Nat Rev Mol Cell Biol"},{"issue":"4","key":"doi230017r27","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1111\/all.1995.50.issue-4","article-title":"Increased levels of serum IgE in children of mothers with systemic lupus erythematosus.","volume":"50","author":"Sasai","year":"1995","journal-title":"Allergy"},{"issue":"9","key":"doi230017r28","doi-asserted-by":"publisher","first-page":"2529","DOI":"10.1007\/s10067-019-04495-4","article-title":"Autoantibodies, elevated cytokines, and neurocognitive abnormalities in offspring of women with systemic lupus erythematosus: comparison with healthy controls.","volume":"38","author":"Gariup","year":"2019","journal-title":"Clin Rheumatol"},{"issue":"1","key":"doi230017r29","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1089\/thy.2006.16.79","article-title":"Thyroid autoantibodies in cord blood sera from children and adolescents with autoimmune thyroiditis.","volume":"16","author":"Svensson","year":"2006","journal-title":"Thyroid"},{"issue":"2","key":"doi230017r30","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s00787-021-01860-0","article-title":"Risk of attention deficit hyperactivity and autism spectrum disorders among the children of parents with autoimmune diseases: a nationwide birth cohort study.","volume":"32","author":"Lee","year":"2023","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"22","key":"doi230017r31","doi-asserted-by":"publisher","first-page":"6041","DOI":"10.1523\/JNEUROSCI.2534-15.2016","article-title":"Maternal Inflammation disrupts fetal neurodevelopment via increased placental output of serotonin to the fetal brain.","volume":"36","author":"Goeden","year":"2016","journal-title":"J Neurosci"},{"issue":"9","key":"doi230017r32","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/j.molmed.2018.06.008","article-title":"The impact of systemic inflammation on neurodevelopment.","volume":"24","author":"Jiang","year":"2018","journal-title":"Trends Mol Med"},{"key":"doi230017r33","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3389\/fncel.2018.00405","article-title":"Immune dysfunction and autoimmunity as pathological mechanisms in autism spectrum disorders.","volume":"12","author":"Hughes","year":"2018","journal-title":"Front Cell Neurosci"},{"issue":"1","key":"doi230017r34","first-page":"11","article-title":"Genetic susceptibility and severity of alopecia areata in human and animal models.","volume":"11","author":"McElwee","year":"2001","journal-title":"Eur J Dermatol"},{"issue":"1","key":"doi230017r35","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jaad.2008.02.005","article-title":"Onset of alopecia areata after Epstein-Barr virus infectious mononucleosis.","volume":"59","author":"Rodriguez","year":"2008","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"doi230017r36","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1354\/vp.40-6-643","article-title":"Alopecia areata in C3H\/HeJ mice involves leukocyte-mediated root sheath disruption in advance of overt hair loss.","volume":"40","author":"McElwee","year":"2003","journal-title":"Vet Pathol"},{"issue":"5","key":"doi230017r37","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s40257-017-0285-x","article-title":"The role of micronutrients in alopecia areata: a review.","volume":"18","author":"Thompson","year":"2017","journal-title":"Am J Clin Dermatol"},{"issue":"4","key":"doi230017r38","doi-asserted-by":"publisher","first-page":"296","DOI":"10.2340\/0001555577296298","article-title":"Stress and alopecia areata: a psychodermatologic study.","volume":"77","author":"Gupta","year":"1997","journal-title":"Acta Derm Venereol"},{"issue":"9","key":"doi230017r39","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1111\/apt.15654","article-title":"Pregnancy outcomes in women with inflammatory bowel disease: a 10-year nationwide population-based cohort study.","volume":"51","author":"Lee","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"issue":"5","key":"doi230017r40","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1016\/j.jaad.2019.11.064","article-title":"Bidirectional association between alopecia areata and major depressive disorder among probands and unaffected siblings: a nationwide population-based study.","volume":"82","author":"Dai","year":"2020","journal-title":"J Am Acad Dermatol"},{"issue":"14","key":"doi230017r41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S146239940601101X","article-title":"Alopecia areata: pathogenesis and potential for therapy.","volume":"8","author":"Lu","year":"2006","journal-title":"Expert Rev Mol Med"},{"issue":"5","key":"doi230017r42","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1016\/j.jaad.2018.10.066","article-title":"Screening of thyroid function and autoantibodies in patients with alopecia areata: a systematic review and meta-analysis.","volume":"80","author":"Lee","year":"2019","journal-title":"J Am Acad Dermatol"},{"issue":"12","key":"doi230017r43","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1111\/jde.2018.45.issue-12","article-title":"Alopecia areata and overt thyroid diseases: a nationwide population-based study.","volume":"45","author":"Han","year":"2018","journal-title":"J Dermatol"},{"issue":"6","key":"doi230017r44","doi-asserted-by":"publisher","first-page":"656","DOI":"10.15537\/smj.2016.6.13777","article-title":"Severe subtype of alopecia areata is highly associated with thyroid autoimmunity.","volume":"37","author":"Bin Saif","year":"2016","journal-title":"Saudi Med J"},{"key":"doi230017r45","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.2147\/CLEP","article-title":"Chronic diseases in the children of women with maternal thyroid dysfunction: a nationwide cohort study.","volume":"10","author":"J\u00f8lving","year":"2018","journal-title":"Clin Epidemiol"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2805463\/jamadermatology_lee_2023_oi_230017_1689096789.14283.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T15:21:06Z","timestamp":1689780066000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2805463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":45,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2023.1261","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}