Perinatal factors for resolution of early-onset eczema by one year old: A Chinese birth cohort in Hong Kong
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摘要Background

Eczema is a common skin disease in Hong Kong. Eczema in most children started within the first 6
months, but its persistence varies. Some babies may ‘outgrow’ this disease with age while others may
follow a life-long episodic course. The determining factors and underlying mechanism are still unclear.
This study aimed to identify perinatal and exposure factors that might predict the persistence of
early-onset eczema.


Method

This birth cohort recruited 120 Chinese healthy term neonates in Hong Kong, regardless of their family
allergic history, who were prospectively followed at 1, 6, and 12 months. Eczema was diagnosed
according to Hanifin and Rajka criteria. Depending on the eczema occurrence at 12 months, babies
previously diagnosed with eczema at 6 months were classified into two phenotypes: early-onset
transient eczema and early-onset persistent eczema. Skin hydration (SH) was measured at left forearm
at 1-month visit. Information on demographics and early-life exposure was obtained from validated
questionnaires during each visit, and use of eczema medications was retrieved from hospital records.
Skin prick test (SPT) for common inhalants and foods was conducted at 12 months. Associations
between eczema outcomes and different demographic, perinatal and exposure factors were analysed by
logistic regression.


Results

Among 120 subjects, sixty (50%) were males, and 36 (30%) had family history of eczema. Forty-four
(45%) of 97 subjects who completed all visits were diagnosed with eczema at 6 months, whereas
eczema resolved by 12 months in 17 babies 30 (68%) out of these 44 subjects had antibiotic exposure
during peripartum period. Univariate analyses showed early-onset transient eczema was associated with
absence of atopy by SPT (OR=10.1, p=0.004). SH measured over left volar forearm at 1 month was
significantly higher among babies with transient eczema than those with persistent disease (63.2±6.3 vs
47.1±5.2; p=0.03). SH of left antecubital fossa at 1 month also showed similar significance (80.8±7.1 vs
68.7±6.2, p=0.03). Peripartum use of antibiotics was strongly associated with early-onset persistent
eczema (aOR=2074, p=0.01).


Conclusion

Higher SH over left forearm at 1 month may predict resolution of infantile eczema, while peripartum
antibiotic exposure may be a risk factor for persistent eczema. These findings implicate potential target
of early intervention which lower the persistence of early-onset eczema. Our results need to be
replicated in larger birth cohorts.
出版社接受日期29.04.2020
著者Yehao Chen, Shuk Man Li, Jennifer Wing-Ki Yau, Kate Ching-ching Chan, Agnes Sze-Yin Leung, Apple Chung-Man Yeung, Cecily Woon-Wa Leung, Nam Sze Cheng, Mei Kam Chang, Wing Hung Tam, Paul Kay-Sheung Chan, Ting Fan Leung
會議名稱EAACI Digital Congress 2020
會議開始日06.06.2020
會議完結日08.06.2020
會議地點Online
會議國家/地區英國
會議論文集題名Allergy
出版年份2020
卷號75
期次Suppl 109
頁次439 - 439
國際標準期刊號0105-4538
語言英式英語
關鍵詞eczema, risk factors, skin

上次更新時間 2021-21-06 於 00:08