Chiesa Fuxench Zelma C, Mitra Nandita, Del Pozo Domenica, Hoffstad Ole, Shin Daniel B, Margolis David J
Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Am Acad Dermatol. 2024 Mar;90(3):561-568. doi: 10.1016/j.jaad.2023.11.013. Epub 2023 Nov 18.
Atopic dermatitis (AD) is thought to precede the onset of other allergic illness (OAI) in a temporal progression (ie, atopic march), yet the timing and progression has been questioned. It is also unclear how parental allergic illness impacts the development of these illnesses in offspring.
(1) Explore risk of incident AD and (2) timing of allergic disease onset in children of mothers with AD compared with mothers without AD from the United Kingdom.
We created a birth cohort of mother-child pairs using IQVIA Medical Research Data database and developed Cox proportional models to examine the above associations (hazard ratio, HR [95% confidence interval, CI]).
Among 1,224,243 child-mother pairs, mean child (standard deviation) follow-up time was 10.8 (8.3) years and 50.1% were males (N = 600,905). Children were 59% (HR = 1.59 [1.57, 1.60]) more likely to have AD if their mothers had AD compared with no AD with mean age of first AD diagnosis at 3.3 (4.8) years. Most children with any diagnosis of AD present with AD first (91.0%); however, in those with asthma, only 67.8% developed AD first.
Children born to mothers with AD are more prone to develop AD and some develop OAI first, suggesting that not all follow the same sequential pathway.
特应性皮炎（AD）被认为在时间进程上（即特应性进程）先于其他过敏性疾病（OAI）发作，但发作时间和进程一直受到质疑。父母的过敏性疾病如何影响后代这些疾病的发展也尚不清楚。
（1）探讨AD发病风险；（2）比较英国患有AD的母亲与未患AD的母亲的子女中过敏性疾病的发病时间。
我们使用IQVIA医学研究数据库创建了一个母婴对出生队列，并开发了Cox比例模型来检验上述关联（风险比，HR[95%置信区间，CI]）。
在1,224,243对母婴中，儿童（标准差）的平均随访时间为10.8（8.3）年，50.1%为男性（N = 600,905）。如果母亲患有AD，其子女患AD的可能性比母亲未患AD的子女高59%（HR = 1.59[1.57, 1.60]），首次AD诊断的平均年龄为3.3（4.8）岁。大多数被诊断患有AD的儿童首先出现AD（91.0%）；然而，在患有哮喘的儿童中，只有67.8%首先出现AD。
患有AD的母亲所生的孩子更容易患AD，有些孩子首先出现OAI，这表明并非所有孩子都遵循相同的顺序路径。
