Sex‐specific developmental trajectories of eczema from infancy to age 26 years: A birth cohort study

Abstract

Background: Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns that are influenced by different risk factors. The aim of this study was to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of prenatal and early-life risk factors. Methods:The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18 and 26 years. In all assessments, eczema was defined as chronic or chronically relapsing itchy dermatitis lasting >6 weeks with characteristic morphology and distribution in the past 12 months. Developmental trajectories of eczema between 1 or 2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results:In both males and females, the following eczema developmental trajectories were identified: unaffected/transient (males: 77.7% vs. females: 73.0%), mid-onset late-resolving (males: 7.8% vs. females: 4.4%), late-onset (males: 5.2% vs. females: 9.5%) and early-onset persistent (males: 9.3% vs. females: 5.4%). In females, an additional trajectory was identified as follows: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34-4.46) and paternal eczema (2.66, 1.39-5.08) were associated with the early-onset persistent trajectory.Among females, maternal eczema (2.84, 1.42-5.70) and high birthweight (2.25, 1.08-4.69) were associated with the early-onset persistent trajectory. Conclusions: Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Our results indicate that males and females may experience a different course of eczema.

Establishing subclasses of childhood eczema, their risk factors and prognosis

“…Moreover, Roduit et al 9 and Suaini et al 10 identified a 4‐class model, they described similar trajectories to the similarly named subclasses in our model with minor differences. Ziyab et al 11 described five sex‐specific trajectories, four trajectories applied to both sexes, these trajectories described similar eczema trends to our results. However, the late onset class, which was a female‐specific trajectory, was not identified in our results.…”

“…7 Five studies have explored this heterogeneity in eczema onset and persistence during early childhood using LCA and its association to other allergic outcomes 7‐11 . However, these studies assessed cross‐sectional associations of eczema subclasses and a limited number of risk factors and comorbidities at 6, 9 8, 10 10, 8 12, 16 7 and 26 11 years. These findings need to be replicated by assessing eczema subclasses targeting high‐risk children with multiple early eczema assessments to draw firmer conclusions and obtain a comprehensive overview of eczema development and progression in childhood.…”

“…7 Five studies have explored this heterogeneity in eczema onset and persistence during early childhood using LCA and its association to other allergic outcomes. [7][8][9][10][11] However, these studies assessed crosssectional associations of eczema subclasses and a limited number of risk factors and comorbidities at 6, 9 8, 10 10, 8 12, 16 7 and 26 11 years.…”

Ultra-processed foods and allergic symptoms among children and adults in the United States: A population-based analysis of NHANES 2005–2006

“…Eczema is a common chronic inflammatory skin disease in children ( 41 , 47 ). Based on the data from the Isle of Wight Birth Cohort, the previous result suggested that men and women may experience various courses of eczema ( 48 ). The developmental trajectories indicated that the prevalence of eczema is equal to or slightly higher in men during adolescence but predominates in women during post-puberty ( 48 ).…”

“…Based on the data from the Isle of Wight Birth Cohort, the previous result suggested that men and women may experience various courses of eczema ( 48 ). The developmental trajectories indicated that the prevalence of eczema is equal to or slightly higher in men during adolescence but predominates in women during post-puberty ( 48 ). Our finding of a positive association between UPFs and eczema in girls suggests that girls with eczema are more susceptible to such low-quality diets.…”