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Pre-birth cohort study of atopic dermatitis and severe bronchiolitis during infancy

Diana S Balekian1,2, Rachel W Linnemann2,3, Victor M Castro4,5

  • 1Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|January 15, 2016
PubMed

Insights

Infants with atopic dermatitis (AD) have a significantly higher risk of severe bronchiolitis. This finding suggests a link between atopic diseases and severe infant respiratory infections, potentially impacting asthma development.

Area of Science:

  • Pediatrics
  • Dermatology
  • Epidemiology

Background:

  • Infants hospitalized for severe bronchiolitis face increased risks of developing childhood asthma.
  • Known risk factors for severe bronchiolitis include cardiac and pulmonary conditions.
  • The association between atopic diseases and severe bronchiolitis risk is less understood, prompting investigation into atopic dermatitis (AD).

Purpose of the Study:

  • To investigate risk factors for severe bronchiolitis in infants.
  • To specifically examine the association between atopic dermatitis (AD) and the risk of severe bronchiolitis.

Main Methods:

  • A nested cohort study was conducted using data from the Massachusetts General Hospital Obstetric Maternal Study (MOMS).
  • Analysis included 5407 children receiving care within the health system, with data extracted from electronic health records.
  • Pregnancy and perinatal risk factors were collected from the MOMS data.

Main Results:

  • During the first year of life, 125 infants (2.3%) experienced severe bronchiolitis.
  • Eighteen of these infants had AD, with 11 diagnosed before their bronchiolitis hospitalization.
  • Multivariable analyses, adjusting for nine known risk factors, showed AD was associated with increased odds of severe bronchiolitis (OR 2.72, 95% CI 1.60-4.63).

Conclusions:

  • Atopic dermatitis is significantly associated with severe bronchiolitis in infancy.
  • The underlying mechanism for the AD-bronchiolitis association requires further research.
  • Understanding this link may offer insights into the pathogenesis of asthma.
Abstract

Keywords:
asthmaatopic dermatitisbirth seasonbronchiolitiscongenital heart diseaseeczemarespiratory syncytial virusrisk factors

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