Open Access Highly Accessed Research article

Early eczema and the risk of childhood asthma: a prospective, population-based study

Marit Saunes124*, Torbjørn Øien1, Christian K Dotterud1, Pål R Romundstad1, Ola Storrø1, Turid L Holmen3 and Roar Johnsen1

Author Affiliations

1 Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway

2 Department of Dermatology, St Olav Hospital, Trondheim University Hospital, Trondheim, Norway

3 HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway

4 Department of Public Health and General Practice, Medical Research Centre (MTFS), NO-7489, Trondheim, Norway

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BMC Pediatrics 2012, 12:168  doi:10.1186/1471-2431-12-168

Published: 24 October 2012

Abstract

Background

Severe eczema in young children is associated with an increased risk of developing asthma and rhino-conjunctivitis. In the general population, however, most cases of eczema are mild to moderate. In an unselected cohort, we studied the risk of current asthma and the co-existence of allergy-related diseases at 6 years of age among children with and without eczema at 2 years of age.

Methods

Questionnaires assessing various environmental exposures and health variables were administered at 2 years of age. An identical health questionnaire was completed at 6 years of age. The clinical investigation of a random subsample ascertained eczema diagnoses, and missing data were handled by multiple imputation analyses.

Results

The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80 (95% CI 1.10-2.96). Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age.

Conclusions

Although most cases of eczema in the general population were mild to moderate, early eczema was associated with an increased risk of developing childhood asthma. These findings support the hypothesis of an atopic march in the general population.

Trial registration

The Prevention of Allergy among Children in Trondheim study has been identified as ISRCTN28090297 in the international Current Controlled Trials database

Keywords:
Eczema; Asthma; Child; Preschool; Cohort; Questionnaires