Differences in Characteristics and Risk Factors between Asthmatic Children with and without Atopic March: A Retrospective Cohort Study

摘要

Background Although asthma occurrence is often preceded by atopic dermatitis (AD) in the context of atopic march, a significant number of asthmatic children do not co-occur with AD. The aim of the study is to explore the phenotypic differences between asthmatic children with and without atopic march. Methods Eligible participants were selected from the 8-year-old survey of Taiwan Birth Cohort Study, and those ever diagnosed as having asthma were enrolled as study subjects. Demographic characteristics, environmental risk factors, and allergic comorbidities including AD of the subjects were retrieved by trained interviewers. We applied logistic regression models to characterize differences between the two groups. Results A total of 1999 asthmatic children were enrolled in the study, and 455 (22.8%) of them had preceding AD. Determinants favoring AD cooccurrence included maternal history of AD (odds ratio [0R]= 2.91, 95% confidence interval [CI]: 1.82-4.64) and allergic rhinitis (OR= 1.29, 95% CI: 1.00-1.65), paternal AD history (OR= 2.45, 95% CI: 1.51-3.99), maternal postpartum depression (OR= 1.37, 95% CI: 1.07-1.75), urbanization of the residence (OR= 1.56,95% CI: 1.24-1.95), higher education of mother (OR= 1.48, 95% CI: 1.13-1.93) and father (OR= 1.32,95% CI: 1.01-1.72), early life food allergy (OR= 3.35, 95% CI: 2.56-4.38), and history of gastritis (0R= 1.46, 95% CI: 1.10-1.93). Nevertheless, asthmatic children with early-onset attention-deficit/hyperactivity disorder were not prone to co-occur with AD (OR= 0.23, 95% CI: 0.08-0.62). Conclusions Early identification of phenotypic determinants between asthmatic children with and without atopic march may help risk stratification and early intervention.