Abstract
BackgroundInfants with atopic eczema have an increased risk of impaired growth, but the origin of this impairment is unclear. The aim of this study was to examine fetal and infant growth in relation to infantile atopic eczema.MethodsWithin the UK Southampton Women’s Survey, 1,759 infants with known maternal menstrual data had anthropometric measurements at 11, 19, and 34 weeks’ gestation, birth, and ages 6 and 12 months, enabling derivation of growth velocity SD scores. Infantile atopic eczema at ages 6 and/or 12 months was ascertained using modified UK Working Party diagnostic criteria.ResultsExpressed per SD increase, higher femur length and abdominal circumference at 34 weeks’ gestation were associated with decreased risks of atopic eczema (eczema OR/SD increase 0.81 [95% CI 0.69–0.96], P=0.017 and 0.78 [95% CI 0.65–0.93], P=0.006, respectively), while every SD increase in head to abdominal circumference ratio (indicating disproportionate growth) was associated with an increase in risk of atopic eczema (1.37 [1.15–1.63], P=0.001). Lower velocities of linear growth from 11 weeks’ gestation to birth and birth to age 6 months were associated with atopic eczema (atopic eczema OR/SD increase 0.80 [0.65–0.98], P=0.034 and 0.8 [1 0.66–1.00], P=0.051, respectively). Infants with atopic eczema at age 12 months had a larger head circumference in early gestation and faltering of abdominal growth velocity from 19 to 34 weeks’ gestation (atopic eczema OR/SD increase 0.67 [0.51–0.88], P=0.003).ConclusionInfants with atopic eczema demonstrate altered patterns of fetal growth, including faltering of linear growth in utero, prior to the clinical onset of atopic eczema. These findings suggest growth falters prior to the start of clinical atopic eczema and its treatment.
Highlights
Linear growth impairment in children with atopic eczema is a clinical concern.[1,2,3] National recommendations in USA,[4] UK,5,6 and other settings are that growth is monitored as part of clinical care for children with atopic eczema
A total of 1,698 infants were assessed for atopic eczema at age 6 months, 9.5% of them had atopic eczema
Postnatal anthropometry showed that infants with atopic eczema at 6 months were shorter at age 6 months and that those with atopic eczema at 12 months were shorter at ages 6 and 12 months
Summary
Linear growth impairment in children with atopic eczema is a clinical concern.[1,2,3] National recommendations in USA,[4] UK, and other settings are that growth is monitored as part of clinical care for children with atopic eczema. Possible reasons for growth faltering have been proposed and include effects of the inflammatory disease,[7] corticosteroid treatment,[8] poor nutrition as a result of an inappropriately restrictive diet,[9] and eczema associated sleep disturbance.[10] Hitherto, little attention has been paid to the possibility of premorbid changes in growth trajectory in infants with atopic eczema. Any such changes in premorbid growth may help explain the growth impairment in children with atopic eczema while providing insights into etiology of the skin disorder.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
