Faltering of prenatal growth precedes the development of atopic eczema in infancy:: cohort study

Abstract

Background: infants with atopic eczema have an increased risk of impaired growth, but the origin of this impairment is unclear. The aim of this study was to examine fetal and infant growth in relation to infantile atopic eczema.

Methods: within the UK Southampton Women’s Survey, 1759 infants with known maternal menstrual data had anthropometric measurements at 11, 19, and 34 weeks’ gestation, birth and ages 6 and 12 months, enabling derivation of growth velocity standard deviation scores. Infantile atopic eczema at ages 6 and/or 12 months was ascertained using modified UK Working Party diagnostic criteria.

Results: expressed per SD increase, higher femur length and abdominal circumference at 34 weeks gestation were associated with decreased risks of atopic eczema (eczema OR /SD increase 0.81 (95%CI 0.69-0.96), p= 0.017; 0.78 (0.65-0.93), p=0.006, respectively), while, every SD increase in head to abdominal circumference ratio (indicating disproportionate growth) was associated with an increase in risk of atopic eczema (1.37(1.15-1.63), p= 0.001). . Lower velocities of linear growth from 11 weeks’ gestation to birth, and birth to age 6 months were associated with atopic eczema age 6 months (atopic eczema OR/SD increase 0.80, 0.65-0.98, p= 0.034; 0.81, 0.66-1.00, p= 0.051, respectively). Infants with atopic eczema age 12 months had a larger head circumference in early gestation and faltering of abdominal growth velocity from 19-34 weeks gestation (atopic eczema OR/SD increase 0.67 (0.51-0.88), p=0.003).

Conclusion: infants with atopic eczema demonstrate altered patterns of fetal growth, including faltering of linear growth in utero, prior to the clinical onset of atopic eczema. The findings suggest growth falters prior to the start of clinical atopic eczema and its treatment.

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Identifiers

ORCID for Sarah El-Heis: orcid.org/0000-0003-4277-7187

ORCID for Sarah R. Crozier: orcid.org/0000-0002-9524-1127

ORCID for Sian M. Robinson: orcid.org/0000-0003-1766-7269

ORCID for Nicholas C. Harvey: orcid.org/0000-0002-8194-2512

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

ORCID for Hazel M. Inskip: orcid.org/0000-0001-8897-1749

ORCID for Janis Baird: orcid.org/0000-0002-4039-4361

ORCID for Keith M. Godfrey: orcid.org/0000-0002-4643-0618

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