Maternal periconceptional folate status and infant atopic dermatitis: A prospective cohort study

Abstract

Background: Maternal folate status is linked with the risk of allergic disorders including atopic dermatitis (AD) in children, but findings remain inconclusive. We aim to assess the relationship between maternal folate status in early gestation and earlyonset infant AD, based on a prospective mother-child cohort study. Methods: Pregnant women were recruited at 12-14 weeks of gestation. Red blood cell folate (RBC folate) and serum folate concentrations were examined at enrollment. Periconceptional folic acid supplementation was investigated through a self-administered questionnaire. The primary outcome was AD incidence before 6 months of age, diagnosed according to Williams' criteria. Multivariate logistic regression was used to evaluate associations of maternal folate status with infant AD by adjusting parental and child covariates. Results: In total, 107 (23.4%) of 458 infants developed AD before 6 months, with more male infants affected (P = .002). Higher maternal RBC folate levels (per 100 ng/ mL) were associated with an increased risk of AD (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.04-1.31). An RBC folate level ≥620 ng/mL was associated with increased infant AD by 91% (aOR 1.91, 95% CI 1.09-3.36). However, associations were not observed for maternal serum folate at early gestation or periconceptional folic acid supplement intakes. Conclusions: We provide the first evidence that higher maternal RBC folate concentrations during early gestation are associated with increased early-onset infant AD. Our findings support the importance of maintaining appropriate folate levels during the periconceptional period to reduce the risk of AD in infants.

Maternal serum 25‐hydroxyvitamin D levels and infant atopic dermatitis: A prospective cohort study

“…The assessment of infant AD has been described in detail in our previous study 21 . Briefly, infant AD was diagnosed according to Williams' criteria by a pediatric dermatologist of the Children's Hospital of Fudan University 22 .…”

“…The present study was based on the birth cohort MKFOAD (ClinicalTrials.gov: NCT02889081), which recruited pregnant women at 12-14 weeks of gestation between June and September 2016 at the Maternal and Child Health Hospital of Minhang District in Shanghai, China. 20,21 Briefly, pregnant women who planned to attend subsequent antenatal care, deliver baby, and attend routine postnatal child care at the study hospital were included, and those with hereditary dermatosis were excluded. Of 518 eligible pregnant women, 487 (94.0%) agreed to participate.…”

“…The assessment of infant AD has been described in detail in our previous study. 21 Briefly, infant AD was diagnosed according to Williams' criteria by a pediatric dermatologist of the Children's Hospital of Fudan University. 22 Infants who were suspected with AD were finally diagnosed at 1 year of age by three experienced pediatric dermatologists through panel discussion.…”

The role of nutrients in human neurodevelopment and their potential to prevent neurodevelopmental adversity

“…Research shows that folate may have a disparate impact on different types of cancer, increasing the risk of breast cancer, but not colon cancer ( 28 , 29 ). As folate is a cofactor for one-carbon transfers and involved in complex biological processes, it was postulated that it might play a role in epigenetic modifications resulting in increased rates of atopic disease in the offspring ( 30 ). This concern may be relevant given rising allergy rates ( 31 ).…”

Trajectory of stratum corneum lipid subclasses in the first year of life and associations with atopic dermatitis: A prospective cohort study

“…3 Atopic dermatitis (AD) affects up to nearly 30% of infants within the first year of life, and over 85% of the cases occur within the first 6 months. [4][5][6] Its etiology is not fully understood but is considered to be different in childhood and adults. 7 Transepidermal water loss (TEWL) levels in the cheek and forehead skin of infants during early life have been documented with prospective association with the risk of infant AD 8 and are associated with CER and FFA concentrations as well as the carbon chain length (CCL) of CER and FFA in AD patients.…”