Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies

J Allergy Clin Immunol. 2013 Sep;132(3):616-622.e7. doi: 10.1016/j.jaci.2013.04.009. Epub 2013 May 24.


Background: Findings on pet exposure and the risk of atopic dermatitis (AD) in children are inconsistent.

Objective: With the aim to summarize the results of exposure to different pets on AD, we undertook a meta-analysis of epidemiologic studies on this issue.

Methods: In August 2012, we conducted a systematic literature search in Medline and Embase. We included analytic studies considering exposure to dogs, cats, other pets, or pets overall during pregnancy, infancy, and/or childhood, with AD assessment performed during infancy or childhood. We calculated summary relative risks and 95% CIs using both fixed- and random-effects models. We computed summary estimates across selected subgroups.

Results: Twenty-six publications from 21 birth cohort studies were used in the meta-analyses. The pooled relative risks of AD for exposure versus no exposure were 0.72 (95% CI, 0.61-0.85; I(2) = 46%; results based on 15 studies) for exposure to dogs, 0.94 (95% CI, 0.76-1.16; I(2) = 54%; results based on 13 studies) for exposure to cats, and 0.75 (95% CI, 0.67-0.85; I(2) = 54%; results based on 11 studies) for exposure to pets overall. No heterogeneity emerged across the subgroups examined, except for geographic area.

Conclusion: This meta-analysis reported a favorable effect of exposure to dogs and pets on the risk of AD in infants or children, whereas no association emerged with exposure to cats.

Keywords: AD; Atopic dermatitis; OR; Odds ratio; RR; Relative risk; child; epidemiology; hygiene hypothesis; pets.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cats / immunology*
  • Cohort Studies
  • Dermatitis, Atopic / epidemiology*
  • Dogs / immunology*
  • Environmental Exposure
  • Humans
  • Pets / immunology*
  • Risk