Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. Millennium Cohort Study

Taylor-Robinson, D.C., Williams, H., Pearce, A. , Law, C. and Hope, S. (2016) Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. Millennium Cohort Study. British Journal of Dermatology, 174(3), pp. 569-578. (doi: 10.1111/bjd.14310) (PMID:26595368) (PMCID:PMC4949701)

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Abstract

Background: Atopic dermatitis (eczema) in childhood is socially patterned, with higher incidence in more advantaged populations. However, it is unclear what factors explain the social differences. Objectives: To identify early-life risk factors for eczema, and to explore how early-life risk factors explain any differences in eczema. Methods: We estimated odds ratios (ORs) for ever having had eczema by age 5 years in 14 499 children from the U.K. Millennium Cohort Study (MCS), with a focus on maternal, antenatal and early-life risk factors and socioeconomic circumstances (SECs). Risk factors were explored to assess whether they attenuated associations between SECs and eczema. Results: Overall 35·1% of children had ever had eczema by age 5 years. Children of mothers with degree-level qualifications vs. no educational qualifications were more likely to have eczema (OR 1·52, 95% confidence interval 1·31–1·76), and there was a gradient across the socioeconomic spectrum. Maternal atopy, breastfeeding (1–6 weeks and ≥ 6 months), introduction of solids under 4 months or cow's milk under 9 months, antibiotic exposure in the first year of life and grime exposure were associated with an increased odds of having eczema. Female sex, Pakistani and Bangladeshi ethnicity, smoking during pregnancy, exposure to environmental tobacco smoke and having more siblings were associated with reduced odds for eczema. Controlling for maternal, antenatal and early-life characteristics (particularly maternal smoking during pregnancy, breastfeeding and number of siblings) reduced the OR for eczema to 1·26 (95% confidence interval 1·03–1·50) in the group with the highest educational qualifications compared with the least. Conclusions: In a representative U.K. child cohort, eczema was more common in more advantaged children. This was explained partially by early-life factors including not smoking during pregnancy, breastfeeding and having fewer siblings.

Item Type:Articles
Additional Information:D.C.T.R. was funded by a Medical Research Council Population Health Scientist Fellowship G0802448 A.P. is funded by a Medical Research Council Population Health Scientist Fellowship (MR/J012351/1).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pearce, Dr Anna
Authors: Taylor-Robinson, D.C., Williams, H., Pearce, A., Law, C., and Hope, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:British Journal of Dermatology
Publisher:Wiley
ISSN:0007-0963
ISSN (Online):1365-2133
Published Online:23 February 2016
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in British Journal of Dermatology 174(3):569-578
Publisher Policy:Reproduced under a Creative Commons License

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