Age at Eczema Onset Influences Risk for Pediatric Asthma

Baby with infantile eczema
Baby with infantile eczema
Researchers hypothesized that the age of asthma onset in children with early-onset eczema would be younger compared with children with asthma and no eczema.

ORLANDO — Early-onset eczema was identified as a risk factor for childhood asthma, according to data presented at the 2018 Joint Congress of the American Academy of Allergy, Asthma & Immunology/World Allergy Organization (AAAAI/WAO), held March 2-5, in Orlando, Florida.

Although eczema has long been known to be a potential risk factor for asthma development, researchers hypothesized that the age of asthma onset in children with early-onset eczema would be younger compared with children with asthma and no eczema.

A total of 988 patients were identified from the Tucson Children’s Respiratory Study, a nonselected birth cohort that enrolled infants between 1980 and 1984 with follow-up visits taking place at multiple ages through 32 years.

Early-onset eczema was diagnosed by a physician before 2 years of age, using a questionnaire completed by the child’s caregiver:

  • Has this child ever had eczema (allergic skin rash)?
  • Has a doctor told you this child had eczema?
  • At what age did the eczema begin?

Asthma was also diagnosed by a physician based on symptoms during the past year and also assessed by questionnaire at multiple time points from age 6 years to age 32 years. 

The prevalence of early eczema was 9.1%: 4.6% beginning by age 6 months and 4.5% beginning between ages 6 and 24 months. More than 80% of patients with eczema were diagnosed with asthma by age 11 years compared with 47.9% of patients without eczema (P <.001). The researchers found no differential risk for asthma if eczema began before or after 6 months of age (P =.4).

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By age 32, children with eczema were twice as likely to develop asthma (hazard ratio [HR], 2.0; 95% CI, 1.5-2.7; P <.001), with a slightly higher risk in male patients (HR, 2.2; 95% CI, 1.5-3.3; P <.001) compared with female patients (HR, 1.7; 95% CI, 1.1-2.7; P =.024). Early-onset eczema in relation to asthma was independent of maternal asthma, sex, race, ethnicity, and atopy at age 6 years (HR, 1.7; 95% CI, 1.2-2.4; P =.002).

“These findings indicate that eczema not only increases an individual’s lifetime risk for asthma, but also increases their risk for developing asthma at a much earlier age,” the researchers concluded.

Reference

Cassell HR, Stern DA, Wright AL, Martinez FD. Early onset eczema and the association with early onset asthma. Presented at: 2018 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress; March 2-5, 2018; Orlando, FL. Poster 413.

This article originally appeared on Pulmonology Advisor