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Eczema in early childhood linked to asthma, rhinitis in older children

Young children with eczema were at three times the risk for developing asthma and nearly as much for rhinitis in later childhood than children without eczema in a recent study.

In a population-based prospective study, researchers in Sweden evaluated 3,124 children (50.5% male), aged 1 to 2 years, in the Dampness in Building and Health study in 2000. They followed up 5 years later with a parental mail-in questionnaire that abided by protocol established by the International Study of Asthma and Allergies in Childhood. Children were predominantly breast-fed (97.4%), lived in a single-family house (82.4%) with nonsmoking parents (77.8%) and had at least one parent with a history of allergies (49%).

At baseline 17.6% of the children had eczema (P<.001). At follow-up children with eczema had three times the odds for developing asthma (adjusted OR=3.07; 95% CI, 1.79-5.27) and more than twice the odds for experiencing rhinitis (aOR=2.63; 95% CI, 1.85-3.73) compared with children without eczema when adjusting for sex, age, family history of allergy, length of breastfeeding and other factors.

Researchers also found other independent factors increased the odds for developing asthma and rhinitis based upon moderate to severe eczema (aOR=3.56; 1.62-7.83 and aOr=3.87; 2.37-6.33, respectively), early onset of eczema (aOR=3.44; 1.94-6.09 and aOR=4.05; 2.82-5.81, respectively) and persistence of eczema for at least 6 months or at baseline and 5-year follow-up (aOR=5.16; 2.62-10.18 and aOR=4.00; 2.53.-6.22, respectively) (all 95% CI).

“Eczema in infancy independently increases the odds of developing asthma and rhinitis during the following 5-year period,” researchers said. “This association is present for children with eczema at baseline; however when they are divided into subgroups [severe eczema, early onset of eczema and persistence of eczema] the odds of the incidence of asthma and rhinitis further increases. Early identification is valuable for prediction of the atopic march.”