Abstract
The influence of early life exposures on later life disease has for some time provided clues to modifiable risk factors of disease. The “atopic march” is thought to play a role in the progression of allergic diseases and may offer an opportunity to lower asthma’s health and socioeconomic burden, although evidence remains controversial. We aimed to examine the relationship between early life eczema and asthma later in life. Using the National Child Development Study, we examined infant eczema and childhood and adult asthma. Data related to asthma or wheezing bronchitis were available for 13,503 (73%; 95% CI 72–74), 11,503 (61%; 95% CI 60–61), 12,524 (68%; 95% CI 67–69), 11,194 (60%; 95% CI 60–60), 9377 (51%; 95% CI 51–51), and 9760 (53%; 95% CI 52–53) subjects at ages 11, 16, 23, 33, 44, and 50 years, respectively. Logistic regression models were fitted to examine each wave separately before and after adjusting for a range of potential confounders. Generalised estimating equation (GEE) methods were undertaken to examine the associations after pooling all data from questionnaires. The prevalence of self-reported asthma in those that had previously reported infant eczema ranged from 1.0%; 95% CI 0.9–1.4 (age 44 years) to 2.2%; 95% CI 2.1–2.3 (age 33 years). Participants with infant eczema had a 2–3-fold increased risk of reporting asthma in childhood and adulthood; this was 1.6 times at age 44 years when using spirometry measures. Similar effect sizes were observed in the GEE models when considering all participants (OR 2.9; 95% CI 2.6–3.2). Childhood and adult asthma were consistently associated with infant eczema both by using the self-reported data and lung measures.
Highlights
The prevalence of allergic diseases represents a significant burden on societies and healthcare systems worldwide [1]
We aimed to examine whether infant eczema perhaps associated with a progression of childhood asthma, and whether it persists into adulthood
We found that effect sizes were greater in analyses using self-reported health outcomes and the intersection between total IgE and spirometry when compared to the analyses at age 44 years, at which point we used participants’ spirometry results
Summary
The prevalence of allergic diseases represents a significant burden on societies and healthcare systems worldwide [1]. Researching potential causal pathways has led to hypotheses into the development of early life eczema and the progression to other allergic phenotypes such as asthma in later life [2]. Case definitions and changing measurements have been found to limit previous studies investigating allergic diseases [3]. A shift from subjective (e.g., self-reported) to objective. Res. Public Health 2018, 15, 1415; doi:10.3390/ijerph15071415 www.mdpi.com/journal/ijerph
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