Which Infants With Eczema Are At Risk Of Food Allergy? Results From A Population Based Study

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Rationale

The risk of food allergy among infants with eczema has rarely been examined in whole population samples. We sought to characterize the risk of challenge-proven food allergy across the spectrum of eczema present in the general population.

Methods

The prevalence of food allergy to peanut, egg white or sesame, measured by oral food challenge, was calculated for 12-month-old infants with or without eczema in the HealthNuts study, Melbourne, Australia. Eczema severity was characterized by age at eczema onset and strength of topical treatment required. 4453 infants were included in the analyses.

Results

One in five infants with eczema were allergic to peanut, egg white or sesame (prevalence 20.9%, 95% CI 19.0, 23.0), compared to one in twenty-five infants without eczema (4.1%, 95% CI 3.4, 4.9, p<0.001). The risk increased to one in two (50.9%, 95% CI 42.8, 58.9) for infants with early eczema onset who required doctor-prescribed topical corticosteroid treatment. Risk factors for food allergy among infants with eczema include maternal allergy (OR 1.3, 95% CI 1.1, 1.7) and East Asian ethnicity (OR

Conclusions

Infants with eczema across the clinical severity spectrum are at increased risk of IgE-mediated food allergy. The risk is greatest among infants with early-onset and more severe eczema. Infants with eczema could be targeted for advice about introduction of food and interventions to reduce the prevalence of food allergy.

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