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Predicting Skin Barrier Dysfunction and Atopic Dermatitis in Early Infancy
Eva Maria Rehbinder1, Kim M Advocaat Endre1, Karin C Lødrup Carlsen2
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Dermatology, Oslo University Hospital, Oslo, Norway.
Insights
Dry skin in infants can predict atopic dermatitis (AD) later in childhood. Specific parental and pregnancy factors also influence dry skin, high transepidermal water loss (TEWL), and AD development.
Area of Science:
- Dermatology
- Pediatrics
- Allergology
Background:
- Dry skin is linked to increased transepidermal water loss (TEWL), a precursor to childhood atopic dermatitis (AD).
- Identifying early predictors is crucial for understanding AD development.
Purpose of the Study:
- To identify parental, prenatal, and perinatal factors predicting dry skin, high TEWL, and AD at 3 months.
- To assess if dry skin or high TEWL at 3 months predicts AD at 6 months.
Main Methods:
- Prospective birth cohort study of 1150 mother-child pairs.
- Assessed dry skin, TEWL, and eczema (as AD proxy) at 3 and 6 months.
- Collected predictive factor data via questionnaires and obstetric charts.
Main Results:
- Paternal age >37 and delivery after 38 weeks predicted dry skin.
- Male sex, winter birth, and maternal allergy predicted high TEWL.
- Elective C-section, multiparity, and maternal allergy predicted eczema.
- Dry skin at 3 months predicted eczema at 6 months (aOR 1.92).
Conclusions:
- Parental and pregnancy factors influence early infant skin conditions and AD risk.
- Infant dry skin at 3 months is a significant predictor of AD development by 6 months.
Background:
Dry skin is associated with increased transepidermal water loss (TEWL), which has been found to precede atopic dermatitis (AD) in childhood.
Objective:
We aimed to identify parental, prenatal, and perinatal predictive factors of dry skin, high TEWL, and AD at 3 months of age, and to determine if dry skin or high TEWL at 3 months can predict AD at 6 months.
Methods:
From the Preventing Atopic Dermatitis and Allergies in children prospective birth cohort study, we included 1150 mother-child pairs. Dry skin, TEWL, and eczema were assessed at 3- and 6-month investigations. Eczema, used as a proxy for AD, was defined as the presence of eczematous lesions, excluding differential diagnoses to AD. High TEWL was defined as TEWL >90th percentile, equaling 11.3 g/m2/h. Potential predictive factors were recorded from electronic questionnaires at 18- and 34-week pregnancy and obstetric charts.
Results:
Significant predictive factors (P < .05) for dry skin at 3 months were delivery >38 gestational weeks and paternal age >37 years; for high TEWL, male sex, birth during winter season, and maternal allergic disease; and for eczema, elective caesarean section, multiparity, and maternal allergic diseases. Dry skin without eczema at 3 months was predictive for eczema at 6 months (adjusted odds ratio: 1.92, 95% confidence interval: 1.21-3.05; P = .005), whereas high TEWL at 3 months was not.
Conclusion:
In early infancy, distinct parental- and pregnancy-related factors were predictive for dry skin, high TEWL, and AD. Dry skin at 3 months of age was predictive for AD 3 months later.
