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Associations of atopic dermatitis and asthma with child behaviour: Results from the PROBIT cohort
Natalia Ballardini1,2,3, Michael S Kramer4, Emily Oken5
1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Insights
Infant atopic dermatitis (AD) did not predict later behavioral issues. However, current AD and asthma symptoms in children are linked to emotional and attention problems.
Area of Science:
- Pediatric Allergy and Immunology
- Child Psychology
- Epidemiology
Background:
- Conflicting research exists on the link between allergic diseases and child behavior.
- Longitudinal studies are needed to clarify these associations.
Purpose of the Study:
- To assess the association between infant atopic dermatitis (AD) and childhood behavioral problems.
- To evaluate the link between asthma and AD symptoms at age 6.5 years with child behavior at the same age.
Main Methods:
- Secondary cohort analysis of the Promotion of Breastfeeding Intervention Trial (PROBIT).
- Data collected from 17,046 infants at birth, followed up to 13,889 at 6.5 years.
- Behavioral assessments included the Strength and Difficulties Questionnaire (SDQ) completed by parents and teachers.
Main Results:
- Infant physician-diagnosed AD did not correlate with increased behavioral problems at 6.5 years.
- AD symptoms and asthma symptoms at 6.5 years were associated with emotional problems (OR 2.24 and 1.45, respectively).
- AD symptoms at 6.5 years were also linked to probable hyperactivity/inattention disorder (OR 2.05).
Conclusions:
- Childhood asthma and AD symptoms are associated with emotional and attention/inattention problems.
- Infant AD is not a predictor of later behavioral issues.
- Findings highlight the importance of addressing current allergic symptoms for managing behavioral comorbidities.
Background:
Conflicting findings from studies evaluating associations of allergic disease with child behaviour require longitudinal studies to resolve.
Objective:
To estimate the magnitude of associations of atopic dermatitis (AD) in infancy, and symptoms of asthma and AD at 6.5 years, with child behaviour at 6.5 years.
Methods:
Secondary cohort analysis of the Promotion of Breastfeeding Intervention Trial (PROBIT). PROBIT enrolled 17 046 infants at birth and followed them up at 6.5 years (n = 13 889). Study paediatricians collected data on infantile AD at repeated follow-up examinations during the first year of life. At 6.5 years, paediatricians performed skin prick tests and parents reported asthma and AD symptoms during the prior year. In addition, parents and teachers completed the Strength and Difficulties Questionnaire, which includes scales on hyperactivity/inattention, emotional problems, conduct problems, peer problems and prosocial behaviours.
Results:
Physician-diagnosed AD in the first year of life was not associated with increased risk for behavioural problems at 6.5 years. Emotional problems at 6.5 years were more common among children with AD symptoms (OR: 2.24, 95% CI: 1.62-3.12) and asthma symptoms (OR: 1.45; 95% CI: 1.07-1.96) during the past year at 6.5 years and ORs for children with symptoms of more severe AD and asthma were also higher. AD in the past year was also associated with probable hyperactivity/inattention disorder at 6.5 years (OR: 2.05; 95% CI: 1.09-3.84). Other subscales of the SDQ were not related to asthma or AD symptoms during the past year.
Conclusions And Clinical Relevance:
Children with AD symptoms were at higher risk for concomitant hyperactivity/inattention and emotional disorder, and children with asthma symptoms were at higher risk of having concomitant emotional problems. However, AD during infancy did not predict childhood behaviours.
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