Neonatal adiposity increases the risk of atopic dermatitis during the first year of life
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Published on: September 27, 2017
Sinéad M O'Donovan1, Jonathan O'B Hourihane2, Deirdre M Murray3
1Vitamin D Research Group, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
Insights
Neonatal adiposity and maternal atopy are significant risk factors for developing atopic dermatitis (AD) in infants. Early identification can aid in managing this common skin condition.
Area of Science:
- Pediatrics
- Dermatology
- Epidemiology
Background:
- Early life nutrition and adiposity are implicated in the development of atopic dermatitis (AD).
- Understanding risk factors in the first year of life is crucial for early intervention.
Purpose of the Study:
- To identify risk factors for atopic dermatitis (AD) during the first year of life.
- Investigate the association between early-life exposures, body composition, and AD development.
Main Methods:
- Prospective data collection from 1537 infants in the Cork BASELINE birth cohort study.
- Assessment of infant feeding, nutritional, and environmental exposures from gestation to 12 months.
- Body composition measured via air displacement plethysmography; AD diagnosis based on UK Working Party Criteria.
Main Results:
- Prevalence of persistent AD (at 6 and 12 months) was 7.5%.
- Maternal history of atopy (aOR 2.99) and neonatal fat mass (aOR 2.31) were significant risk factors for AD.
- Exclusive breastfeeding decreased from 35% at discharge to 14% by 2 months.
Conclusions:
- Neonatal adiposity is a novel predictor of atopic dermatitis (AD) at 6 and 12 months.
- This study highlights the importance of early life factors in AD development.
- Findings are from a well-characterized birth cohort with a focus on atopic diseases.
Background:
Early nutrition and adiposity have been linked to atopic dermatitis (AD) development.
Objective:
We sought to describe risk factors for AD in the first year of life in infants participating in the Cork BASELINE birth cohort study (n = 1537).
Methods:
Prospective data on early-life events, infant feeding, and nutritional and environmental exposures were collected at 15 weeks' gestation, birth, and 2, 6, and 12 months of age. Body composition was assessed by using air displacement plethysmography at day 2 and 2 months. The primary outcome, persistent AD, was determined if the U.K. Working Party Diagnostic Criteria were satisfied at both 6 and 12 months.
Results:
At 6 and 12 months, the point prevalence of AD was 14.2% (99% CI, 10.5% to 17.8%) and 13.7% (99% CI, 10.3% to 17.6%), respectively; 7.5% (99% CI, 5.0% to 9.9%) of infants had AD at both 6 and 12 months of age. At hospital discharge, 35% of infants were exclusively breast-fed, decreasing to 14% by 2 months. Complementary feeding was commenced at a median of 19 weeks (interquartile range, 17-22 weeks; 19% at <17 weeks and 6% at ≥26 weeks). Median fat mass at day 2 was 0.35 kg (interquartile range, 0.25-0.48 kg). A parental history of atopic disease was self-reported by 43% of mothers and 34% of fathers. Risk factors for AD at 6 and 12 months were maternal atopy (adjusted odds ratio, 2.99; 99% CI, 1.35-6.59; P = .0004) and fat mass of the 80th percentile or greater at day 2 (adjusted odds ratio, 2.31; 99% CI, 1.02-2.25; P = .009).
Conclusion:
This is the first report of neonatal adiposity as a predictor of AD at 6 and 12 months of age in a well-characterized atopic disease-specific birth cohort.
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