Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study
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Emilia Vassilopoulou1, Dimitrios Rallis2, Gregorio Paolo Milani1,3
1Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Insights
Maternal smoking and older sibling history increase infant atopic dermatitis (AD) risk. Cesarean delivery and unguided food elimination in AD infants heighten food allergy risks. Early interventions are key.
Area of Science:
- Pediatrics
- Allergology
- Epidemiology
Background:
- Atopic dermatitis (AD) in infancy often precedes food allergies, affecting millions globally.
- Prenatal and postnatal risk factors for AD and subsequent food allergies require further elucidation.
- Understanding early-life influences is crucial for preventing allergic diseases.
Purpose of the Study:
- To investigate the epidemiology of atopic dermatitis (AD) in infancy.
- To identify prenatal and postnatal risk factors associated with AD development.
- To examine the link between early-life factors and the later onset of food allergies.
Main Methods:
- A prospective cohort study included 501 infants from January to December 2019.
- Longitudinal data were collected via maternal interviews at birth and 24–36 months postpartum.
- Data included demographics, family history, maternal smoking, antibiotic use, delivery mode, breastfeeding, food practices, and early greenness exposure.
Main Results:
- Maternal smoking during pregnancy and older sibling history of atopy were significantly linked to AD incidence (p=0.001, p=0.03).
- Cesarean section delivery (p=0.04) and unguided food elimination (p=0.02) were associated with increased food allergy risk in infants with AD.
- Home garden presence correlated with a higher likelihood of AD (p=0.01).
Conclusions:
- Promoting timely allergenic food introduction and dietary diversity, alongside maternal smoking cessation and professional dietary guidance, may reduce AD and food allergy risks.
- Future research should explore the role of greenness exposure in the development of AD and food allergies.
- Targeted interventions based on identified risk factors are essential for prevention.
Background:
Atopic dermatitis (AD) at a young age often precedes the development of food allergies. Although AD affects millions of infants worldwide, prenatal and postnatal risk factors, and their association with the development of food allergies later on, are not fully elucidated. This study seeks to investigate AD epidemiology in infancy and its risk factors, examining early-life factors (both prenatal and postnatal) that could contribute to the later development of food allergies.
Methods:
Between January 2019 and December 2019, 501 infants were included in this prospective cohort study. Longitudinal data collection was performed through maternal interviews, the first one conducted within three days after the delivery and the second within 24 to 36 months after the delivery, encompassing variables such as demographics, family history of atopy, maternal smoking, antibiotic use during pregnancy, the mode of delivery, breastfeeding history, food practices, and greenness exposure within 3 days from delivery, while they were still in the hospital.
Results:
Maternal smoking during pregnancy (p = 0.001) and an older sibling atopy history (p = 0.03) was significantly linked to AD incidence. Cesarean section delivery (p = 0.04) was associated with a higher risk of food allergies in infants with AD. Having a garden at home correlated with a higher likelihood of AD (p = 0.01), and food elimination without medical guidance (p = 0.02) due to AD correlated with an elevated risk of food allergies.
Conclusions:
Encouraging timely allergenic food introduction while promoting dietary diversity, rich in plant-based foods, maternal smoking cessation, and professional dietary guidance may help minimize AD and food allergy risk. Future studies should address the role of greenness in the development of AD and food allergies.
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