Birth mode is associated with development of atopic dermatitis in infancy and early childhood

Sveinung T. Hoel, MD; Johanna Wiik, MD, PhD; Karin C.L. Carlsen, MD, PhD; Kim M.A. Endre, MD, PhD; Hrefna Katrín Gudmundsdóttir, MD; Guttorm Haugen, MD, PhD; Angela Hoyer, MSc; Christine Monceyron Jonassen, PhD; Marissa LeBlanc, MSc, PhD; Björn Nordlund, RN, PhD; Knut Rudi, PhD; Håvard O. Skjerven, MD, PhD; Anne Cathrine Staff, MD, PhD; Gunilla Hedlin, MD, PhD; Cilla Söderhäll, MSc, PhD; Riyas Vettukattil, MD, PhD; Hilde Aaneland, RN; Eva M. Rehbinder, MD, PhD

Journal of Allergy and Clinical Immunology: Global (Aug 2023)

Birth mode is associated with development of atopic dermatitis in infancy and early childhood

Sveinung T. Hoel, MD,
Johanna Wiik, MD, PhD,
Karin C.L. Carlsen, MD, PhD,
Kim M.A. Endre, MD, PhD,
Hrefna Katrín Gudmundsdóttir, MD,
Guttorm Haugen, MD, PhD,
Angela Hoyer, MSc,
Christine Monceyron Jonassen, PhD,
Marissa LeBlanc, MSc, PhD,
Björn Nordlund, RN, PhD,
Knut Rudi, PhD,
Håvard O. Skjerven, MD, PhD,
Anne Cathrine Staff, MD, PhD,
Gunilla Hedlin, MD, PhD,
Cilla Söderhäll, MSc, PhD,
Riyas Vettukattil, MD, PhD,
Hilde Aaneland, RN,
Eva M. Rehbinder, MD, PhD

Affiliations

Sveinung T. Hoel, MD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Corresponding author: Sveinung Torsteinsen Hoel, MD, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Johanna Wiik, MD, PhD: Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway; Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
Karin C.L. Carlsen, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Kim M.A. Endre, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
Hrefna Katrín Gudmundsdóttir, MD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Guttorm Haugen, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
Angela Hoyer, MSc: Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
Christine Monceyron Jonassen, PhD: Centre for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway; Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
Marissa LeBlanc, MSc, PhD: Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
Björn Nordlund, RN, PhD: Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
Knut Rudi, PhD: Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
Håvard O. Skjerven, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Anne Cathrine Staff, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
Gunilla Hedlin, MD, PhD: Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
Cilla Söderhäll, MSc, PhD: Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
Riyas Vettukattil, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Hilde Aaneland, RN: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Eva M. Rehbinder, MD, PhD: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway

Journal volume & issue: Vol. 2, no. 3
p. 100104

Abstract

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Background: Birth by caesarean section (CS) is associated with development of allergic diseases, but its role in the development of atopic dermatitis (AD) is less convincing. Objective: Our primary aim was to determine if birth mode was associated with AD in 3-year-olds and secondarily to determine if birth mode was associated with early onset and/or persistent AD in the first 3 years of life. Methods: We included 2129 mother–child pairs from the Scandinavian population-based prospective PreventADALL cohort with information on birth mode including vaginal birth, either traditional (81.3%) or in water (4.0%), and CS before (6.3%) and after (8.5%) onset of labor. We defined early onset AD as eczema at 3 months and AD diagnosis by 3 years of age. Persistent AD was defined as eczema both in the first year and at 3 years of age, together with an AD diagnosis by 3 years of age. Results: AD was diagnosed at 3, 6, 12, 24, and/or 36 months in 531 children (25%). Compared to vaginal delivery, CS was overall associated with increased odds of AD by 3 years of age, with adjusted odds ratio (95% confidence interval) of 1.33 (1.02-1.74), and higher odds of early onset AD (1.63, 1.06-2.48). The highest odds for early onset AD were observed in infants born by CS after onset of labor (1.83, 1.09-3.07). Birth mode was not associated with persistent AD. Conclusion: CS was associated with increased odds of AD by 3 years of age, particularly in infants presenting with eczema at 3 months of age.

Published in Journal of Allergy and Clinical Immunology: Global

ISSN: 2772-8293 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/journal-of-allergy-and-clinical-immunology-global

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