Risk factors for asthma occurrence in children with early-onset atopic dermatitis: An 8-year follow-up study

Pediatr Allergy Immunol. 2018 Mar;29(2):159-165. doi: 10.1111/pai.12835. Epub 2017 Dec 19.


Background: Children with early-onset atopic dermatitis (AD) are at substantial risk of developing asthma later in life, and identifying the critical window of detrimental exposure is advantageous for implementing preventive actions. The aim of this study was to evaluate the role of exposure to environmental modifiers during pregnancy and early childhood in asthma occurrence in an infantile AD cohort.

Methods: Eligible study participants were selected from the Taiwan Birth Cohort Study, which enrolled 24 200 newborns in 2005. We enrolled those cases who had been diagnosed as having AD before 3 years of age and followed them up till age 8. We excluded those ever diagnosed with asthma before AD onset. The dependent variable was defined in terms of whether the participant was diagnosed as having asthma before 8 years of age. We applied logistic regression models to evaluate the risks of exposure to different determinants in asthma occurrence.

Results: A total of 1549 children with AD had completed the 8-year follow-up, and 334 (21.6%) of them had asthma. The results revealed that male sex, lower birth order, maternal asthma history, maternal obesity before pregnancy, and environmental tobacco smoke exposure before 3 years of age were significant risk factors for further development of asthma. Furthermore, food allergy during early life, lower respiratory tract infection, and longer durations of symptomatic AD influenced asthma development later in life.

Conclusions: The findings confirmed the critical determinants for asthma occurrence in infantile AD, which may enable a more personalized approach to the prevention of asthma.

Keywords: Taiwan Birth Cohort Study; environmental tobacco smoke; food allergy; obesity; pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma / epidemiology*
  • Asthma / etiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Dermatitis, Atopic / complications*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Registries
  • Risk Factors
  • Taiwan / epidemiology