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A multinational study to compare prevalence of atopic dermatitis in the first year of life
Eelco Draaisma1, Luis Garcia-Marcos2,3, Javier Mallol4
1Princess Amalia Children's Centre, Isala Hospital, Zwolle, the Netherlands.
Insights
Infant atopic dermatitis (AD) prevalence varies significantly by region, with higher rates in Central America than Europe. Risk factors like family history of allergies are consistent, but other factors may differ in infants compared to older children.
Area of Science:
- Pediatrics
- Dermatology
- Epidemiology
Background:
- Atopic dermatitis (AD) is a common childhood condition, particularly in early life.
- International prevalence studies have predominantly focused on older children, leaving a gap in infant data.
- This study investigated geographical variations in infant AD prevalence and associated factors.
Purpose of the Study:
- To compare the prevalence of atopic dermatitis (AD) in 1-year-old infants across different countries.
- To identify risk and protective factors associated with infantile AD in diverse geographical settings.
- To explore potential differences in AD pathophysiology between infants and older children.
Main Methods:
- Utilized data from 9803 infants participating in the International Study of Wheezing in Infants (EISL).
- Assessed AD prevalence and risk/protective factors through parental questionnaires.
- Employed random effects meta-analysis to calculate odds ratios for identified factors.
Main Results:
- Infantile AD prevalence ranged from 10.6% in Spain to 28.2% in Honduras, with higher average rates in Central America (18.2%) than Europe (14.2%).
- Consistent risk factors included family history of asthma, rhinitis, and atopic dermatitis, as well as having siblings.
- Factors like gender, family size, breastfeeding, and socioeconomic status showed no significant association with AD prevalence.
Conclusions:
- Significant geographical disparities exist in infant atopic dermatitis prevalence, with nearly threefold differences observed.
- Risk and protective factors for infantile AD may differ from those in older children, suggesting distinct underlying mechanisms.
- Further international epidemiological research on AD in young children is crucial due to its peak prevalence during this age.
Background:
Atopic dermatitis (AD) is common in childhood, with peak prevalence in early childhood. However, international comparisons of prevalence have focused on older children. We analysed differences in prevalence rates of AD and the associations with putative risk and protective factors, among infants in two European and two Central American countries.
Methods:
In 1-yr old infants participating in the International Study of Wheezing in Infants (EISL), prevalence of AD and putative risk and protective factors were assessed by a questionnaire applied to parents. For each risk/protective factor summary, odds ratios with 95% confidence intervals were calculated by means of random effects meta-analysis.
Results:
Data from 9803 infants were analysed. AD prevalence varied from 10.6% (Valencia, Spain) to 28.2% (San Pedro Sula, Honduras). Average AD prevalences were lower in Europe (14.2%) than in Central America (18.2%, p < 0.01). Consistent with older children, presence of siblings decreased (OR 0.82 [0.72-0.94]), whereas family history of asthma (OR 1.32 [1.10-1.59]), rhinitis (OR 1.33 [1.14-1.54]) and atopic dermatitis (OR 2.40 [1.89-3.05]) increased the risk of infantile AD. However, gender, family size, breastfeeding and socio-economic status were not associated with AD prevalence.
Conclusions:
This study shows almost threefold differences in the prevalence of AD in infancy between countries. Risk and protective factors involved in the expression of infantile AD differ from those in older children, possibly suggesting a different pathophysiology. There is a need for additional international epidemiological surveys on AD in young children, the peak prevalence age of this condition.
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