Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort

Abstract

BackgroundThis study aimed to estimate the association between eczema in early childhood and the onset of asthma and rhinitis later in life in children.MethodsA total of 3,124 children aged 1–2 years were included in the Dampness in Building and Health (DBH) study in the year 2000, and followed up 5 years later by a parental questionnaire based on an International Study of Asthma and Allergies in Childhood protocol. The association between eczema in early childhood and the incidence of asthma and rhinitis later in life was estimated by univariable and multivariable logistic regression modelling.ResultsThe prevalence of eczema in children aged 1–2 years was 17.6% at baseline. Children with eczema had a 3-fold increased odds of developing asthma (adjusted odds ratio [aOR], 3.07; 95% confidence interval (CI) 1.79–5.27), and a nearly 3-fold increased odds of developing rhinitis (aOR, 2.63; 1.85–3.73) at follow-up compared with children without eczema, adjusted for age, sex, parental allergic disease, parental smoking, length of breastfeeding, site of living, polyvinylchloride flooring material, and concomitant allergic disease. When eczema was divided into subgroups, moderate to severe eczema (aOR, 3.56; 1.62–7.83 and aOR, 3.87; 2.37–6.33, respectively), early onset of eczema (aOR, 3.44; 1.94–6.09 and aOR, 4.05; 2.82–5.81; respectively), and persistence of eczema (aOR, 5.16; 2.62–10.18 and aOR, 4.00; 2.53–6.22, respectively) further increased the odds of developing asthma and rhinitis. Further independent risk factors increasing the odds of developing asthma were a parental history of allergic disease (aOR, 1.83; 1.29–2.60) and a period of breast feeding shorter than 6 months (aOR, 1.57; 1.03–2.39). The incidence of rhinitis was increased for parental history of allergic disease (aOR, 2.00; 1.59–2.51) and polyvinylchloride flooring (aOR, 1.60; 1.02–2.51).ConclusionEczema in infancy is associated with development of asthma and rhinitis during the following 5-year period, and eczema is one of the strongest risk factors. Early identification is valuable for prediction of the atopic march.

Development of Respiratory Allergies, Asthma and Allergic Rhinits in Children with Atopic Dermatitis

“…Regarding the severity of AD, Gustafsson et al 2 , Ricci et al 16 and Illi et al 17 found that children with high severity scores were at an increased risk of developing asthma. Kobyletzki et al 18 also found higher odds of developing asthma and AR for the moderate and severe forms of AD in comparison with the mild form of AD. Our results are slightly different from these, as we found a signifi cantly high risk of developing both diseases for the severe and moderate forms of AD, whereas 7 children with the mild form of AD also developed asthma.…”

“…Th e results of various studies suggest that the early onset of AD is one of the most important risk factors for developing asthma and AR in children with AD. Kobyletzki et al 18 also point out that the early onset was a strong risk factor for the incidence of asthma (OR 3.44) and AR. Similar results were obtained by Illi et al 17 and Kelbore et al 19 , who suggest that early onset, but also parental atopic history, increase the odds of developing asthma and AR.…”

Predictors of allergen sensitization in Singapore children from birth to 3 years

“…A study from Sweden that followed 3124 children to 5 years reported that onset of eczema in the first year of life was associated with increased risk of developing asthma and rhinitis, while later onset of eczema was not [24]. De Benedetto [25] reviewed data suggesting that several epidermal alarmins may lead to a Th2 immune response when the skin barrier is compromised.…”

Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant

“…Eczema in early life is one of the strongest risk factors for subsequent development of atopic diseases such as allergic rhinoconjunctivitis or asthma in later life. 13 Cumulative incidence of eczema was considered to be the most relevant and reliable outcome measure because the chronic and relapsing course of the affliction may render point prevalence unreliable. 14 Eczema was diagnosed according to the criteria introduced by Hanifin, 15 based on the following features: pruritus, typical morphology and distribution, and a chronic relapsing course.…”