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Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence

Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence
Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence
Background: cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema.

Objective: since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence.

Methods: we obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1‐to‐2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid_BF_duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1‐or‐2 to4 years, 4‐10, and 10‐18 years we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements.

Results: if the mother smoked during gestation, longer Resid_BF_duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid_BF_duration if the mother smoked during gestation.

Conclusions and clinical relevance: esults suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
0954-7894
1688-1697
Mukherjee, Nandini
f64f02d6-2fd0-40db-88ee-5f85b59b8e0b
Sutter, Thomas R.
b6d8c8a9-fca5-4726-bd3f-a65c72a3680f
Arshad, Syed
917e246d-2e60-472f-8d30-94b01ef28958
Holloway, John
4bbd77e6-c095-445d-a36b-a50a72f6fe1a
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Mukherjee, Nandini
f64f02d6-2fd0-40db-88ee-5f85b59b8e0b
Sutter, Thomas R.
b6d8c8a9-fca5-4726-bd3f-a65c72a3680f
Arshad, Syed
917e246d-2e60-472f-8d30-94b01ef28958
Holloway, John
4bbd77e6-c095-445d-a36b-a50a72f6fe1a
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853

Mukherjee, Nandini, Sutter, Thomas R., Arshad, Syed, Holloway, John, Zhang, Hongmei and Karmaus, Wilfried (2018) Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence. Clinical and Experimental Allergy, 48 (12), 1688-1697. (doi:10.1111/cea.13294).

Record type: Article

Abstract

Background: cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema.

Objective: since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence.

Methods: we obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1‐to‐2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid_BF_duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1‐or‐2 to4 years, 4‐10, and 10‐18 years we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements.

Results: if the mother smoked during gestation, longer Resid_BF_duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid_BF_duration if the mother smoked during gestation.

Conclusions and clinical relevance: esults suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.

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Unmarked revised manuscript Sept 25 2018 - Accepted Manuscript
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Supplementary material september 25 2018 - Accepted Manuscript
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More information

Accepted/In Press date: 8 October 2018
e-pub ahead of print date: 12 October 2018
Published date: 1 December 2018

Identifiers

Local EPrints ID: 425376
URI: http://eprints.soton.ac.uk/id/eprint/425376
ISSN: 0954-7894
PURE UUID: 922b3b57-b5a6-486c-a133-1cefb3de3cbb
ORCID for John Holloway: ORCID iD orcid.org/0000-0001-9998-0464

Catalogue record

Date deposited: 16 Oct 2018 16:30
Last modified: 22 Nov 2021 06:49

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Contributors

Author: Nandini Mukherjee
Author: Thomas R. Sutter
Author: Syed Arshad
Author: John Holloway ORCID iD
Author: Hongmei Zhang
Author: Wilfried Karmaus

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