Prenatal maternal stress and the risk of allergic rhinitis in offspring: A systematic review and meta-analysis.

BACKGROUND: Prenatal maternal stress influences the development of the fetal immune system and may increase the risk of allergic rhinitis (AR) in childhood. This meta-analysis provides a systematic assessment of the relationship between maternal stress during pregnancy and the subsequent occurrence of AR in offspring. OBJECTIVE: To explore the relationship between prenatal maternal stress and the risk of AR in offspring. METHODS: Articles were searched by using PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang databases. A meta-analysis was performed on 9 studies published up to May 20th, 2026, was conducted for statistical analysis with STATA16.0. The association between prenatal maternal stress and offspring AR was quantitatively assessed by calculating pooled odds ratio (OR) with corresponding 95% confidence interval (95% CI). Potential publication bias was assessed through funnel plots as well as Egger's and Begg's tests. RESULTS: A total of 9 studies involving 40,630 participants were included after systematic literature screening. Meta-analysis showed that prenatal maternal stress was significantly associated with an increased risk of AR in offspring (OR = 1.69, 95% CI:1.51-1.86, P < 0.001, I2 = 47.78%). Stratified analysis by stress type showed a gradient effect: the risk of AR was lowest for prenatal anxiety (OR = 1.42, 95% CI:1.20-1.63, P < 0.001, I2 = 42.67%), followed by depression (OR = 1.61, 95%CI:1.40-1.82, P < 0.001, I2 = 54.74%), and highest for stressful life events (OR = 1.74, 95% CI:1.29-2.18, P < 0.001, I2 = 70.04%). CONCLUSIONS: Prenatal maternal stress can increase the risk of AR in children. Various types of maternal stress experienced during pregnancy exhibit a notable gradient effect on the likelihood of children developing allergic rhinitis subsequently.