Study suggests eczema develops in pregnancy
Researchers have found new evidence that atopic eczema develops before birth and is linked to a child’s growth in the womb and shortly after birth.
The study, presented at the British Association of Dermatologists’ Annual Meeting in Edinburgh (3 to 5 July) found that infants with eczema demonstrated altered patterns of growth during pregnancy, including impairment in growth of length starting in early pregnancy, prior to eczema becoming evident.
The findings suggest that growth is impaired prior to the start of the disease process and its treatment, and that there are important influences acting on this skin condition during pregnancy.
Looking at children in the Southampton Women’s Survey, 1759 infants had serial measurements of their length, head and abdominal circumference during pregnancy at 11, 19 and 34 weeks, at birth, and at ages six and 12 months, and were assessed for eczema at ages six and/or 12 months.
Evidence of faltering growth in length from 11 weeks of pregnancy and shorter femur length, smaller abdominal circumference and a higher head to abdominal circumference ratio at 34 weeks’ gestation were associated with 20% or greater increased risks of eczema at age six months.
Infants who had had a larger head circumference in early pregnancy and a declining abdominal growth velocity from 19 to 34 weeks’ gestation had a 33% greater likelihood of eczema at age 12 months.
According to researchers, a possible explanation for the findings is ‘brain sparing’ responses where the growth of the head and brain takes priority over the growth of the rest of the body.
One organ that could be affected is the thymus, which is important in regulating the immune system, and this could result in an imbalance in immune cells and chemicals producing the inflammatory response seen in atopic eczema.
Lead researcher from the University of Southampton and the MRC Lifecourse Epidemiology Unit Dr Sarah El-Heis said: ‘Infants with eczema have an increased risk of impaired growth, which is a clinical concern that underpins recommendations to monitor growth in all infants with eczema.
‘A number of reasons for the impaired growth have been proposed and include effects of the inflammatory process, topical corticosteroid treatment or an inappropriately restrictive diet.
‘However, we have shown that infants with eczema at age six and 12 months have altered growth patterns before they are born and before eczema becomes evident, suggesting that there are important influences acting during pregnancy.’