title: Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age.
abstract: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood.
  
  
  
  A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups.
  
  
  
  Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7-6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2-5 years, OR = 2.7, 95% CI = 1.0-7.2) and early-onset persistent eczema (onset from 6-24 months, OR = 2.3, 95% CI = 1.2-4.7). Late-onset eczema (commenced from 2-5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1-8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4-4.1).
  
  
  
  Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.|Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
authors.forename: Adrian J
authors.identifier: 0000-0002-4691-8162
authors.initials: AJ
authors.lastname: Lowe
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Bianca
authors.initials: B
authors.lastname: Angelica
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|Monash University, Eastern Health, Melbourne, Vic., Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: John
authors.initials: J
authors.lastname: Su
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.|Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Lodge
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hill
authors.affiliation: School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia.
authors.forename: Bircan
authors.initials: B
authors.lastname: Erbas
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.|Centre for Population Health Research, Deakin University, Melbourne, Vic., Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bennett
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Lyle C
authors.initials: LC
authors.lastname: Gurrin
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Axelrad
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Abramson
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Vic., Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Allen
authors.affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.|Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001249:Asthma / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D004485:Eczema / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology*; D012306:Risk
keywords: allergic rhinitis; asthma; eczema; epidemiology; natural history; risk factors