001 Does atopic dermatitis in childhood impact later educational attainment? A UK birth cohort study

Abstract

Abstract Atopic dermatitis (AD) may impair educational attainment in numerous ways, including poor attention due to itching and disrupted sleep quality. Educational attainment is a social determinant of health; thus, any association with AD, a prevalent chronic disease, is important to understand. We aimed to determine whether AD is associated with lower educational attainment using data collected between 1990 and 2009 on children enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) and linked to the National Pupil Database. Participants were 13,956 children alive at 1 year of age and followed up with repeated measures of AD until 11.5 years of age. The outcome was educational attainment, defined as achieving at least five General Certificates of Secondary Education (GCSEs) at grades A*–C by 16 years of age. Using multivariable logistic regression, we assessed the effect of AD on educational attainment, adjusting for potential confounders. We included 7577 children in a complete record analysis: 3258 (43.0%) with evidence of AD (two positive AD reports) and 4319 (57.0%) without AD reports (comparator group). Compared with children without AD, children with AD had 30% increased odds of attaining ≥ 5 A*–C GCSEs [adjusted odds ratio (aOR) 1.30, 95% confidence interval (CI) 1.17–1.45]. Children with AD had a 9.9% absolute excess probability of achieving ≥ 5 A*–C GCSEs vs. children without AD. In a stratified analysis, asthma was shown to enhance the strength of the association of AD with educational attainment [probability in AD vs. no AD groups: 62.7% vs. 47.3%; aOR 1.58, 95% CI 1.19–2.10 (P = 0.04 for interaction)]. AD appeared to be associated with higher educational attainment in English children. Despite the magnitude and strength of the findings, cautious interpretation is required due to the dichotomous outcome measure, poor generalizability and potential unmeasured confounding. Further investigations should evaluate reproducibility in other populations, stratify by AD trajectory–severity phenotypes and use quantitative test scores.