Division of Allergy Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Obstetrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Allergy. 2015 Nov;70(11):1477-84. doi: 10.1111/all.12706. Epub 2015 Sep 10.
Atopic dermatitis affects 15-30% of children worldwide. Onset of disease usually occurs within the first year of life, over half of which regress by 6 years of age. The aim of this study was to investigate the risk factors related to the persistence of infantile atopic dermatitis.
In this birth cohort study, patients were enrolled prenatally and followed until 6 years of age; 246 patients had infantile atopic dermatitis at 6 months of age. Family history, maternal and paternal total and specific Immunoglobulin E (IgE) levels, and cord blood IgE were recorded. Clinical examination, questionnaire survey, and blood samples for total and specific IgE of the children were collected at each follow-up visit.
Of the 246 patients with infantile atopic dermatitis at 6 months of age, 48 patients had persisted atopic dermatitis at 6 years of age (19.5%). Risk factors associated with persistent infantile atopic dermatitis included egg white sensitization (odds ratio: 3.801, P = 0.020), and atopic dermatitis involving two or more areas at 6 months old (odds ratio: 2.921, P = 0.018) after multivariate analysis with logistic regression. Patients with persistent infantile atopic dermatitis had a higher risk of asthma before 6 years old (39.6% vs 24.2%, P = 0.032).
Egg white sensitization and the initial involvement of two or more areas at 6 months of age were associated with the persistent infantile atopic dermatitis. Patients with persistent infantile atopic dermatitis are more likely to develop asthma by 6 years of age.
特应性皮炎影响全球 15-30%的儿童。疾病通常在生命的第一年发作，其中超过一半在 6 岁前消退。本研究旨在探讨与婴儿特应性皮炎持续相关的危险因素。
在这项出生队列研究中，患者在产前入组并随访至 6 岁；246 例患儿在 6 个月时患有婴儿特应性皮炎。记录家族史、母亲和父亲的总免疫球蛋白 E（IgE）和特异性 IgE 水平，以及脐带血 IgE。在每次随访时进行临床检查、问卷调查以及儿童总 IgE 和特异性 IgE 血样采集。
在 246 例 6 个月时患有婴儿特应性皮炎的患者中，48 例在 6 岁时仍患有特应性皮炎（19.5%）。多因素逻辑回归分析显示，与持续性婴儿特应性皮炎相关的危险因素包括蛋清过敏（优势比：3.801，P=0.020）和 6 个月时累及两个或更多部位的特应性皮炎（优势比：2.921，P=0.018）。持续性婴儿特应性皮炎患者在 6 岁前患哮喘的风险更高（39.6%比 24.2%，P=0.032）。
蛋清过敏和 6 个月时累及两个或更多部位与婴儿特应性皮炎的持续存在有关。持续性婴儿特应性皮炎患者在 6 岁前更有可能患哮喘。
