title: Febrile and gynecological infections during pregnancy are associated with a greater risk of childhood eczema.
abstract: BACKGROUND
  Mounting evidence suggests that fetal exposures may exert long-term effects on the function of the skin and of the immune system. This study aimed at assessing whether maternal complications during pregnancy are associated with an increased risk of eczema during childhood.
  
  
  METHODS
  The associations between hypertension/preeclampsia, febrile infections, or gynecological infections during pregnancy and the occurrence of childhood eczema were studied in a population (n = 3907) of children, aged 3-14 yrs, living in Italy. Their parents filled in a standardized questionnaire about the presence of children's eczema and the events that occurred during pregnancy, birth, and the first year of the child's life.
  
  
  RESULTS
  7.7%, 3.8%, and 6.1% of the pregnancies were complicated by hypertension/preeclampsia, febrile infections, and gynecological infections, respectively. The prevalence of eczema was significantly higher in children born to mothers who had experienced febrile (35.5% vs. 22.0%; p < 0.001) or gynecological infections (35.3% vs. 21.6%; p < 0.001) compared with those born to mothers who had not suffered from that specific pregnancy complication, while hypertension/preeclampsia was not significantly associated with childhood eczema. After adjusting for potential confounders, the risk of eczema was significantly higher in children born to mothers who reported febrile infections during the 1st trimester (OR: 2.32; 95% CI: 1.11-4.82) and gynecological infections during the 3rd trimester of pregnancy (OR: 2.73; 95% CI:1.73-4.31).
  
  
  CONCLUSIONS
  Fetal exposure to febrile and gynecological infections might enhance the risk of eczema in the offspring, especially when occurring in specific trimesters of pregnancy. These findings suggest that febrile and gynecological infections might interfere with fetal and perinatal programming of the immune function and skin through different mechanisms.
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pesce
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marcon
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Marchetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.forename: Roberto
authors.initials: R
authors.lastname: de Marco
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004485:Eczema / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D060737:Reproductive Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: allergy; atopy; children; dermatitis; epidemiology; fetal exposures; gestation; prenatal exposures; skin; vaginitis