PRENATAL exposure to endocrine-disrupting chemicals appears associated with an increased risk of childhood atopic dermatitis according to a growing body of epidemiological evidence.
Endocrine-Disrupting Chemicals and Early-Life Risk
The review outlines how atopic dermatitis remains one of the most common chronic inflammatory conditions in children, with a global prevalence that continues to rise. Although incidence has stabilized in many high-income countries, a significant upward trend persists across low- and middle-income regions. The authors describe prenatal exposure to endocrine-disrupting chemicals as a key environmental factor that may influence this divergence. These chemicals, which include per- and polyfluoroalkyl substances, bisphenol A, parabens, triclosan, and phthalate esters, are widespread in consumer and industrial settings. Epidemiological studies increasingly suggest that maternal exposure during pregnancy may elevate the risk of atopic dermatitis in early childhood, yet the strength and consistency of this association vary across study designs and populations.
Gaps in Evidence and Ongoing Challenges
Despite accumulating data, considerable uncertainty remains. Exposure assessment differs substantially across studies, with variability in biospecimen type, timing of collection, and analytical methods. Population heterogeneity further complicates interpretation, as genetic background, environmental context, and socioeconomic conditions influence both chemical exposure patterns and dermatologic outcomes. The review emphasizes that real-world exposure typically involves numerous endocrine-disrupting chemicals simultaneously, creating mixtures that are difficult to evaluate through traditional epidemiological frameworks. Mechanistic pathways also remain insufficiently defined, limiting the ability to directly link prenatal exposure to later immune dysregulation or skin barrier alteration.
Future Directions in Understanding Exposure and Disease
To address these limitations, the review highlights the need for multi-omics integration within large, prospective cohort studies. Combining genomics, metabolomics, proteomics, and exposomics may clarify how endocrine-disrupting chemicals interact with biological systems during fetal development. These approaches could reveal critical exposure windows, illuminate dose–response relationships, and identify biomarkers that improve early detection and prevention strategies. Strengthening the evidence base may ultimately support targeted early-life interventions that reduce the burden of childhood atopic dermatitis and inform broader environmental health policies aimed at limiting prenatal exposure to endocrine-disrupting chemicals.
Reference: Chen Y et al. Prenatal exposure to endocrine-disrupting chemicals and childhood atopic dermatitis: epidemiological evidence. Front Microbiol. 2025;16:1681214.
