Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age

Adrian J. Lowe, Bianca Angelica, John Su, Caroline J Lodge, David J. Hill, Bircan Erbas, Catherine M Bennett, Lyle C Gurrin, Christine Axelrad, Michael J. Abramson, Katrina J. Allen, Shyamali C. Dharmage

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. Methods: A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. Results: Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7–6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2–5 years, OR = 2.7, 95% CI = 1.0–7.2) and early-onset persistent eczema (onset from 6–24 months, OR = 2.3, 95% CI = 1.2–4.7). Late-onset eczema (commenced from 2–5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1–8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4–4.1). Conclusion and clinical relevance: Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.

Original languageEnglish
Pages (from-to)384-390
Number of pages7
JournalPediatric Allergy and Immunology
Volume28
Issue number4
DOIs
Publication statusPublished - 1 Jun 2017

Keywords

  • allergic rhinitis
  • asthma
  • eczema
  • epidemiology
  • natural history
  • risk factors

Cite this

Lowe, Adrian J. ; Angelica, Bianca ; Su, John ; Lodge, Caroline J ; Hill, David J. ; Erbas, Bircan ; Bennett, Catherine M ; Gurrin, Lyle C ; Axelrad, Christine ; Abramson, Michael J. ; Allen, Katrina J. ; Dharmage, Shyamali C. / Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age. In: Pediatric Allergy and Immunology. 2017 ; Vol. 28, No. 4. pp. 384-390.
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title = "Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age",
abstract = "Background: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. Methods: A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. Results: Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95{\%} CI = 1.7–6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2–5 years, OR = 2.7, 95{\%} CI = 1.0–7.2) and early-onset persistent eczema (onset from 6–24 months, OR = 2.3, 95{\%} CI = 1.2–4.7). Late-onset eczema (commenced from 2–5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95{\%} CI=1.1–8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95{\%} CI = 1.4–4.1). Conclusion and clinical relevance: Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.",
keywords = "allergic rhinitis, asthma, eczema, epidemiology, natural history, risk factors",
author = "Lowe, {Adrian J.} and Bianca Angelica and John Su and Lodge, {Caroline J} and Hill, {David J.} and Bircan Erbas and Bennett, {Catherine M} and Gurrin, {Lyle C} and Christine Axelrad and Abramson, {Michael J.} and Allen, {Katrina J.} and Dharmage, {Shyamali C.}",
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Lowe, AJ, Angelica, B, Su, J, Lodge, CJ, Hill, DJ, Erbas, B, Bennett, CM, Gurrin, LC, Axelrad, C, Abramson, MJ, Allen, KJ & Dharmage, SC 2017, 'Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age' Pediatric Allergy and Immunology, vol. 28, no. 4, pp. 384-390. https://doi.org/10.1111/pai.12714

Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age. / Lowe, Adrian J.; Angelica, Bianca; Su, John; Lodge, Caroline J; Hill, David J.; Erbas, Bircan; Bennett, Catherine M; Gurrin, Lyle C; Axelrad, Christine; Abramson, Michael J.; Allen, Katrina J.; Dharmage, Shyamali C.

In: Pediatric Allergy and Immunology, Vol. 28, No. 4, 01.06.2017, p. 384-390.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age

AU - Lowe, Adrian J.

AU - Angelica, Bianca

AU - Su, John

AU - Lodge, Caroline J

AU - Hill, David J.

AU - Erbas, Bircan

AU - Bennett, Catherine M

AU - Gurrin, Lyle C

AU - Axelrad, Christine

AU - Abramson, Michael J.

AU - Allen, Katrina J.

AU - Dharmage, Shyamali C.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. Methods: A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. Results: Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7–6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2–5 years, OR = 2.7, 95% CI = 1.0–7.2) and early-onset persistent eczema (onset from 6–24 months, OR = 2.3, 95% CI = 1.2–4.7). Late-onset eczema (commenced from 2–5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1–8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4–4.1). Conclusion and clinical relevance: Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.

AB - Background: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. Methods: A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. Results: Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7–6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2–5 years, OR = 2.7, 95% CI = 1.0–7.2) and early-onset persistent eczema (onset from 6–24 months, OR = 2.3, 95% CI = 1.2–4.7). Late-onset eczema (commenced from 2–5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1–8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4–4.1). Conclusion and clinical relevance: Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.

KW - allergic rhinitis

KW - asthma

KW - eczema

KW - epidemiology

KW - natural history

KW - risk factors

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