A Birth Cohort Study On The Natural Course And Predisposing Factors Of Infant Atopic Dermatitis

Objective: To observe the skin condition of infants one year after birth and to study natural course and predisposing factors of infant atopic dermatitis(AD)in the early stage.Methods: By using the neonatal birth cohort study model,newborns were enrolled in Xinhua Hospital since October 2018.The Chinese diagnostic criteria of infant atopic dermatitis were applied.Admission criteria:normal fetuses delivered in Xinhua Hospital had no history of rescue after birth;exclusion criteria: neonatal ABO hemolytic disease,neonatal asphyxia,ischemic hypoxic encephalopathy,intracranial hemorrhage,intrauterine infection,neonatal infectious diseases,congenital malformations or congenital heart disease;the termination and shedding criteria: during follow-up,infants were found to have genetic metabolic diseases,severe immune defects,loss of follow-up or death,guardians voluntarily asked to withdraw from the study or poor compliance.At the end of follow-up,the incidence model of early atopic dermatitis was summarized according to the development of AD in the group.Meanwhile the predisposing factors of atopic dermatitis were analyzed by chi-square test and unconditional logic regression.Results: From October 2018 to May 2019,a total of 203 newborns were enrolled,of which 163 completed one-year follow-up.The cumulative incidence of atopic dermatitis in infants reached 39.04%,with an average onset time of 10.15±4.99 weeks.The earliest onset of AD infant was 4 weeks old,with a total of 4 infants;the first rash of atopic dermatitis was mainly occurred in the cheek(53.23%).Early onset of infantile seborrheic dermatitis(P<0.001,OR=4.473)increases the susceptibility of atopic dermatitis.Conclusion:According to the new diagnostic criteria of infant atopic dermatitis in China,the cumulative prevalence rate of AD in infants within one year is 39.04%.The first onset site is mainly in the cheek,and the earliest onset time is 4 weeks old.Seborrheic dermatitis is a predisposing factor for AD.There may be a pattern of infantile seborrheic dermatitis-atopic dermatitis.