Atopic Dermatitis and Risk of Inflammatory Bowel Disease in Children: A Systematic Review and Meta-Analysis

Atopic dermatitis (AD) is a chronic inflammatory skin condition predominantly affecting children, and emerging evidence suggests a potential association with inflammatory bowel disease (IBD). This systematic review and meta-analysis aimed to quantify the risk of developing IBD, Crohn's disease (CD), and ulcerative colitis (UC) in children with AD compared with those without. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted from inception to June 2025. Cohort and case-control studies involving children aged 0-18 years with a diagnosis of AD and reporting IBD as an outcome were eligible for inclusion. Study quality was assessed using the Newcastle-Ottawa Scale, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Four studies were included in the meta-analysis. Pooled analysis demonstrated that children with AD had a significantly increased risk of IBD compared with controls (OR: 1.44; 95% CI: 1.26-1.64), with substantial heterogeneity across studies (I² = 70%). Subgroup analyses revealed elevated risks for both CD (OR: 1.46; 95% CI: 1.13-1.90) and UC (OR: 1.27; 95% CI: 1.02-1.59). Leave-one-out sensitivity analysis confirmed the stability and robustness of these findings. In conclusion, children with AD are at a significantly increased risk of developing IBD, highlighting the need for heightened clinical awareness of gastrointestinal comorbidities in this population and warranting further prospective paediatric research.