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特应性皮炎儿童 6 岁时的神经发育。

Neurodevelopment at 6 years of age in children with atopic dermatitis.

机构信息

Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.

Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea.

出版信息

Allergol Int. 2023 Jan;72(1):116-127. doi: 10.1016/j.alit.2022.08.002. Epub 2022 Sep 2.

Abstract

BACKGROUND

Few studies have reported an association between atopic dermatitis and cognitive impairment in children. Therefore, we evaluated the association between atopic dermatitis (AD) and neurodevelopmental dysfunction in children.

METHODS

We analyzed 2,395,966 children born between 2008 and 2012 in Korea. All data were acquired from the databases of the Korean National Health Insurance System. AD was defined as five or more diagnoses before age 24 months. The outcome was suspected neurodevelopmental dysfunction in the gross motor skill, fine motor skill, cognition, language, sociality, and self-care domains of the Korean Developmental Screening Test for Infants and Children at age 6 years. The positive control outcome was defined as attention deficit hyperactive disorder (ADHD). The associations were assessed using ordinal logistic regression, adjusting for asthma and allergic rhinitis.

RESULTS

Among the eligible children, 89,452 and 30,557 were allocated to the control and AD groups, respectively. In the weighted data, the AD group showed a higher risk of suspected neurodevelopmental dysfunction in the total score (weighted adjusted odds ratio [95% CI] 1.10 [1.05-1.16]), gross motor skills (1.14 [1.04-1.25]), and fine motor skills (1.15 [1.06-1.25]) than the control group. The AD with steroids or hospitalization groups showed an increased risk of suspected neurodevelopmental dysfunction. In addition, the AD group showed a significant association with mental retardation, psychological development disorder, and behavioral and emotional disorders as well as ADHD.

CONCLUSIONS

AD before age 2 years may be associated with an increased risk of neurodevelopmental dysfunction including gross and fine motor skills in the young childhood period.

摘要

背景

鲜有研究报道特应性皮炎与儿童认知障碍之间的相关性。因此,我们评估了特应性皮炎(AD)与儿童神经发育功能障碍之间的关系。

方法

我们分析了 2008 年至 2012 年期间在韩国出生的 2395966 名儿童的数据。所有数据均来自韩国国家健康保险系统数据库。AD 的定义为 24 个月前有五次或以上的诊断。6 岁时,使用婴幼儿韩国发展筛查测试的粗大运动技能、精细运动技能、认知、语言、社交和自理领域评估疑似神经发育功能障碍。阳性对照结果定义为注意缺陷多动障碍(ADHD)。采用有序逻辑回归评估相关性,调整哮喘和过敏性鼻炎的影响。

结果

在合格儿童中,分别有 89452 名和 30557 名儿童被分配到对照组和 AD 组。在加权数据中,AD 组的总分(加权调整后的优势比[95%CI]为 1.10[1.05-1.16])、粗大运动技能(1.14[1.04-1.25])和精细运动技能(1.15[1.06-1.25])存在疑似神经发育障碍的风险更高。使用类固醇或住院治疗的 AD 组显示疑似神经发育障碍风险增加。此外,AD 组与智力低下、心理发育障碍、行为和情绪障碍以及 ADHD 显著相关。

结论

2 岁前的 AD 可能与儿童早期的神经发育障碍(包括粗大运动和精细运动技能)风险增加相关。

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