title: Environmental and dietary risk factors for infantile atopic eczema among a Slovak birth cohort.
abstract: Infantile atopic eczema (AE) is a risk marker for future asthma. This study assesses the contribution of modifiable exposures to infantile AE. If modifiable exposures contribute substantially to infantile AE, its prevention might be a sensible approach to asthma prevention. Pregnant women (n = 1978) were systematically recruited from maternity hospitals of the Slovak Republic; their birthed cohort of 1990 children were prospectively followed for 1 yr. Children's exposures to selected environmental and dietary factors were assessed via maternal questionnaires administered at delivery and 1 yr of age. A child was considered to have AE, based on physical examination (SCORAD index >2) or mother's report of a previous physician diagnosis. Multivariate logistic regression was used to calculate adjusted odds ratios and percent total regression scores (TRS) for each variable. At 1 yr of age 1326 (67%) of the children remained in the cohort and 207 (15.6%) developed AE. Various modifiable environmental and dietary exposures increased the likelihood of AE (ownership of cats; consumption of infant formula, eggs, and fish) while others decreased the likelihood of AE (ownership of livestock; exclusive breast feeding for > or =4 months). Overall, modifiable exposures contributed less to the TRS than did non-modifiable exposures (38% vs. 62%, respectively). The modifiable exposure category that contributed most to the TRS was infant feeding practices (27.5% TRS). Modifiable exposures -- especially those related to infant feeding practices -- significantly contribute to infantile AE, although modifiable factors contribute less overall than do non-modifiable exposures.
authors.affiliation: Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. amlang@emory.edu
authors.forename: Anne L
authors.initials: AL
authors.lastname: Dunlop
authors.forename: Eva
authors.initials: E
authors.lastname: Reichrtova
authors.forename: Luba
authors.initials: L
authors.lastname: Palcovicova
authors.forename: Peter
authors.initials: P
authors.lastname: Ciznar
authors.forename: Andrea
authors.initials: A
authors.lastname: Adamcakova-Dodd
authors.forename: S J
authors.initials: SJ
authors.lastname: Smith
authors.forename: Scott J N
authors.initials: SJ
authors.lastname: McNabb
mesh_terms: D000328:Adult; D001249:Asthma / Q000517:prevention & control; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D018154:Slovakia