Related Experiment Video
Updated: Jan 9, 2026
Regulation of Hormone Secretion
Risk of developing asthma in young children with atopic eczema: a systematic review
Annelies E van der Hulst1, Helen Klip, Paul L P Brand
1Princess Amalia Children's Clinic, Isala Klinieken, Zwolle, The Netherlands.
Insights
Children with early atopic eczema have an increased risk of developing childhood asthma. However, only about one-third of these children develop asthma, a lower rate than previously thought.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Epidemiology
Background:
- Common belief: most infants with atopic eczema develop childhood asthma.
- Belief based on cross-sectional studies.
- Emerging evidence suggests a more complex eczema-asthma relationship.
Purpose of the Study:
- Assess the risk of asthma development in children with atopic eczema within the first four years of life.
Main Methods:
- Systematic review of prospective cohort studies.
- Pooled data to calculate asthma risk in children with early eczema.
- Included birth cohort and eczema cohort studies.
Main Results:
- Pooled odds ratio for asthma after eczema (birth cohorts): 2.14 (95% CI, 1.67-2.75).
- Asthma prevalence at age 6 in eczema cohorts: 35.8% (inpatients), 29.5% (inpatients/outpatients).
Conclusions:
- Early childhood eczema increases asthma risk.
- Approximately one-third of children with eczema develop asthma later.
- Findings impact counseling for atopic eczema patients and parents.
Background:
It is commonly believed that the majority of infants and young children with early atopic eczema will develop asthma in later childhood. This belief is mainly based on cross-sectional population studies. Recent evidence suggests a more complex relationship between early eczema and asthma.
Objective:
This systematic review was conducted to assess the risk of developing asthma in children with atopic eczema during the first 4 years of life.
Methods:
A sensitive search was performed to identify all prospective cohort studies on the topic. By pooling the eligible reports, we calculated the risk of developing asthma at 6 years of age or older in children with atopic eczema in the first 4 years of life.
Results:
Thirteen prospective cohort studies were included, with 4 representing birth cohort studies and 9 representing eczema cohort studies. The pooled odds ratio for the risk of asthma after eczema, compared with children without eczema, in birth cohort studies was 2.14 (95% CI, 1.67-2.75). The prevalence of asthma at the age of 6 years in eczema cohort studies was 35.8% (95% CI, 32.2% to 39.9%) for inpatients and 29.5% (95% CI, 28.2% to 32.7%) for a combined group of inpatients and outpatients.
Conclusion:
Although there is an increased risk of developing asthma after eczema in early childhood, only 1 in every 3 children with eczema develops asthma during later childhood. This is lower than previously assumed.
Clinical Implications:
Our results may have important consequences for counseling patients with atopic eczema and their parents.
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