Differences in Occurrence, Risk Factors and Severity of Early-onset Atopic Dermatitis among Preterm and Term Children

Area of Science:

• Neonatal and Developmental Pediatrics
• Dermatology
• Genetics

Background:

• Atopic dermatitis (eczema) is a common inflammatory skin condition.
• Understanding early-life risk factors and disease presentation in preterm versus term infants is crucial for targeted interventions.

Purpose of the Study:

• To compare the incidence, age of onset, severity, and risk factors of atopic dermatitis in preterm and term newborns during their first year of life.
• To investigate the role of filaggrin gene mutations in atopic dermatitis development in these two groups.

Main Methods:

• Prospective birth cohort study of 150 preterm and 300 term newborns.
• Clinical diagnosis of atopic dermatitis and severity assessment using the Eczema Area Severity Index (EASI).
• Analysis of filaggrin gene mutations and parental reporting of environmental exposures and emollient use.

Main Results:

• Atopic dermatitis occurred in 21.2% of infants, being significantly more common in term infants (26.7%) than preterm infants (11.7%).
• Term infants showed an earlier age of onset (4 months vs. 6 months) and more severe disease (EASI 4.8 vs. 0.4) at onset.
• Filaggrin gene mutations were less frequent in preterm infants (4.1%) compared to term infants (9.2%).

Conclusions:

• Term infants are at a higher risk for developing atopic dermatitis in the first year of life, characterized by earlier onset and greater severity.
• While most environmental risk factors were similar, seasonal birth (winter/autumn) appeared to influence risk.
• Lower prevalence of filaggrin gene mutations in preterm infants may contribute to their reduced risk.