Differences in Occurrence, Risk Factors and Severity of Early-onset Atopic Dermatitis among Preterm and Term Children
DOI:
https://doi.org/10.2340/actadv.v102.575Keywords:
Atopic dermatitis, premature birth, risk factors, cohort studyAbstract
This prospective birth cohort followed 150 preterm and 300 term newborns during the first year of life to assess possible differences in risk factors, age at onset, anatomical location, and severity of atopic dermatitis. Atopic dermatitis was diagnosed clinically, and severity was assessed using Eczema Area Severity Index (EASI). DNA was analysed for filaggrin gene mutations. Parents were asked about environmental exposures and emollient use. Atopic dermatitis during the first year of life was observed in 21.2% of children and was more common in term children compared with preterm children (26.7% vs 11.7%, p < 0.001), with lower age of onset (4 vs 6 months, p < 0.05) and more severe disease at onset (EASI: 4.8 vs 0.4, p < 0.0005). Environmental risk factors for atopic dermatitis were essentially similar for preterm and term born children, apart from winter and autumn births. Filaggrin gene mutations were less common in preterm than term children (4.1% vs 9.2%, p = 0.06).
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Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers 2018; 4: 1.
https://doi.org/10.1038/s41572-018-0001-z DOI: https://doi.org/10.1038/s41572-018-0001-z
Kim JP, Chao LX, Simpson EL, Silverberg JI. Persistence of atopic dermatitis (AD): a systematic review and meta-analysis. J Am Acad Dermatol 2016; 75: 681-687.e11.
https://doi.org/10.1016/j.jaad.2016.05.028 DOI: https://doi.org/10.1016/j.jaad.2016.05.028
Brunner PM. Early immunologic changes during the onset of atopic dermatitis. Ann Allergy Asthma Immunol 2019; 123: 152-157.
https://doi.org/10.1016/j.anai.2019.03.033 DOI: https://doi.org/10.1016/j.anai.2019.03.033
Weidinger S, Novak N. Atopic dermatitis. The Lancet 2016; 387: 1109-1122.
https://doi.org/10.1016/S0140-6736(15)00149-X DOI: https://doi.org/10.1016/S0140-6736(15)00149-X
Engebretsen KA, Bager P, Wohlfahrt J, Skov L, Zachariae C, Nybo Andersen AM, et al. Prevalence of atopic dermatitis in infants by domestic water hardness and season of birth: Cohort study. J Allergy Clin Immunol 2017; 139: 1568-1574.e1.
https://doi.org/10.1016/j.jaci.2016.11.021 DOI: https://doi.org/10.1016/j.jaci.2016.11.021
Calov M, Alinaghi F, Hamann CR, Silverberg J, Egeberg A, Thyssen JP. The association between season of birth and atopic dermatitis in the northern hemisphere: a systematic review and meta-analysis. J Allergy Clin Immunol Pract 2020; 8: 674-680.e5.
https://doi.org/10.1016/j.jaip.2019.10.007 DOI: https://doi.org/10.1016/j.jaip.2019.10.007
Ahn K. The role of air pollutants in atopic dermatitis. J Allergy Clin Immunol 2014; 134: 993-999; discussion 1000.
https://doi.org/10.1016/j.jaci.2014.09.023 DOI: https://doi.org/10.1016/j.jaci.2014.09.023
Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol 2013; 132: 616-622.e7.
https://doi.org/10.1016/j.jaci.2013.04.009 DOI: https://doi.org/10.1016/j.jaci.2013.04.009
Drislane C, Irvine AD. The role of filaggrin in atopic dermatitis and allergic disease. Ann Allergy Asthma Immunol 2020; 124: 36-43.
https://doi.org/10.1016/j.anai.2019.10.008 DOI: https://doi.org/10.1016/j.anai.2019.10.008
Smieszek SP, Welsh S, Xiao C, Wang J, Polymeropoulos C, Birznieks G, et al. Correlation of age-of-onset of atopic dermatitis with filaggrin loss-of-function variant status. Scientific Reports 2020; 10.
https://doi.org/10.1038/s41598-020-59627-7 DOI: https://doi.org/10.1038/s41598-020-59627-7
Barbarot S, Gras-Leguen C, Colas H, Garrot E, Darmaun D, Larroque B, et al. Lower risk of atopic dermatitis among infants born extremely preterm compared with higher gestational age. Br J Dermatol 2013; 169: 1257-1264.
https://doi.org/10.1111/bjd.12581 DOI: https://doi.org/10.1111/bjd.12581
Tronnes H, Wilcox AJ, Lie RT, Markestad T, Moster D. The association of preterm birth with severe asthma and atopic dermatitis: a national cohort study. Pediatr Allergy Immunol 2013; 24: 782-787.
https://doi.org/10.1111/pai.12170 DOI: https://doi.org/10.1111/pai.12170
Egeberg A, Andersen YM, Gislason G, Skov L, Thyssen JP. Neonatal risk factors of atopic dermatitis in Denmark - results from a nationwide register-based study. Pediatr Allergy Immunol 2016; 27: 368-374.
https://doi.org/10.1111/pai.12560 DOI: https://doi.org/10.1111/pai.12560
Kvenshagen B, Jacobsen M, Halvorsen R. Atopic dermatitis in premature and term children. Arch Dis Child 2009; 94: 202-205.
https://doi.org/10.1136/adc.2008.142869 DOI: https://doi.org/10.1136/adc.2008.142869
Gerner T, Halling-Sønderby A, Rinnov MR RN, Knudgaard MH, Bonefeld CM EC, Trautner S, et al. 'Barrier dysfunction in Atopic newBorns studY' (BABY): protocol of a Danish prospective birth cohort study. BMJ Open 2020; 10: e033801.
https://doi.org/10.1136/bmjopen-2019-033801 DOI: https://doi.org/10.1136/bmjopen-2019-033801
Meldgaard M, Szecsi PB, Carlsen BC, Thyssen JP, Johansen JD, Menne T, et al. A novel multiplex analysis of filaggrin polymorphisms: a universally applicable method for genotyping. Clin Chim Acta 2012; 413: 1488-1492.
https://doi.org/10.1016/j.cca.2012.06.014 DOI: https://doi.org/10.1016/j.cca.2012.06.014
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377-381.
https://doi.org/10.1016/j.jbi.2008.08.010 DOI: https://doi.org/10.1016/j.jbi.2008.08.010
Tronnes H, Wilcox AJ, Markestad T, Tollanes MC, Lie RT, Moster D. Associations of maternal atopic diseases with adverse pregnancy outcomes: a national cohort study. Paediatr Perinat Epidemiol 2014; 28: 489-497.
https://doi.org/10.1111/ppe.12154 DOI: https://doi.org/10.1111/ppe.12154
Saito S, Nakashima A, Shima T, Ito M. Th1/Th2/Th17 and regulatory T-cell paradigm in pregnancy. Am J Reprod Immunol 2010; 63: 601-610.
https://doi.org/10.1111/j.1600-0897.2010.00852.x DOI: https://doi.org/10.1111/j.1600-0897.2010.00852.x
Ravn NH, Halling AS, Berkowitz AG, Rinnov MR, Silverberg JI, Egeberg A, et al. How does parental history of atopic disease predict the risk of atopic dermatitis in a child? - a systematic review and meta-analysis. J Allergy Clin Immunol 2020; 145: 1182-1193.
https://doi.org/10.1016/j.jaci.2019.12.899 DOI: https://doi.org/10.1016/j.jaci.2019.12.899
Thorsteinsdottir S, Thyssen JP, Stokholm J, Vissing NH, Waage J, Bisgaard H. Domestic dog exposure at birth reduces the incidence of atopic dermatitis. Allergy 2016; 71: 1736-1744.
https://doi.org/10.1111/all.12980 DOI: https://doi.org/10.1111/all.12980
Simpson A, John SL, Jury F, Niven R, Woodcock A, Ollier WE, et al. Endotoxin exposure, CD14, and allergic disease: an interaction between genes and the environment. Am J Respir Crit Care Med 2006; 174: 386-392.
https://doi.org/10.1164/rccm.200509-1380OC DOI: https://doi.org/10.1164/rccm.200509-1380OC
Herbarth O, Fritz GJ, Rehwagen M, Richter M, Roder S, Schlink U. Association between indoor renovation activities and eczema in early childhood. Int J Hyg Environ Health 2006; 209: 241-247.
https://doi.org/10.1016/j.ijheh.2006.01.003 DOI: https://doi.org/10.1016/j.ijheh.2006.01.003
Lee JY, Seo JH, Kwon JW, Yu J, Kim BJ, Lee SY, et al. Exposure to gene-environment interactions before 1 year of age may favor the development of atopic dermatitis. Int Arch Allergy Immunol 2012; 157: 363-371.
https://doi.org/10.1159/000328778 DOI: https://doi.org/10.1159/000328778
Chalmers JR, Haines RH, Bradshaw LE, Montgomery AA, Thomas KS, Brown SJ, et al. Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial. The Lancet 2020; 395: 962-972.
https://doi.org/10.1016/S0140-6736(19)32984-8 DOI: https://doi.org/10.1016/S0140-6736(19)32984-8
Skjerven HO, Rehbinder EM, Vettukattil R, LeBlanc M, Granum B, Haugen G, et al. Skin emollient and early complementary feeding to prevent infant atopic dermatitis (PreventADALL): a factorial, multicentre, cluster-randomised trial. The Lancet 2020; 395: 951-961.
https://doi.org/10.1016/S0140-6736(19)32983-6 DOI: https://doi.org/10.1016/S0140-6736(19)32983-6
Rittase M, Kirkland E, Dudas DM, Patel AV. Survey item response rates by survey modality, language, and sociodemographic factors in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 2020; 29: 724-730.
https://doi.org/10.1158/1055-9965.EPI-19-0757 DOI: https://doi.org/10.1158/1055-9965.EPI-19-0757
Bliddal M, Liew Z, Pottegard A, Kirkegaard H, Olsen J, Nohr EA. Examining nonparticipation in the maternal follow-up within the Danish national birth cohort. Am J Epidemiol 2018; 187: 1511-1519.
https://doi.org/10.1093/aje/kwy002 DOI: https://doi.org/10.1093/aje/kwy002
Mortz CG, Andersen KE, Bindslev-Jensen C. Recall bias in childhood atopic diseases among adults in the Odense Adolescence Cohort Study. Acta Derm Venereol 2015; 95: 968-972.
https://doi.org/10.2340/00015555-2128 DOI: https://doi.org/10.2340/00015555-2128
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Copyright (c) 2022 Trine Gerner, Maria Rasmussen Rinnov, Anne-Sofie Halling, Nina Haarup Ravn, Mette Hjorslev Knudgaard, Caroline Ewertsen, Simon Trautner, Ivone Jakasa, Sanja Kezic, Lone Skov, Jacob P. Thyssen
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