OBJECTIVETo explore the predictive value of cord blood 25(OH)D [25(OH)D] for infantile atopic dermatitis (AD), and to provide a reference for primary prevention of early infantile AD.

METHODSThe neonates born from July to September, 2015 were enrolled. The cord blood samples were collected at birth to measure the level of 25(OH)D. Outpatient follow-up was conducted for all the infants at 6 weeks, 3 months, and 6 months after birth. A survey was performed to investigate the incidence of AD.

RESULTSA total of 67 neonates completed a 6-month follow-up. The incidence of AD was 34% (23/67), and 91% (21/23) of these cases occurred in the first month after birth. The 23 AD children had a significantly lower cord 25(OH)D level than those without AD (P<0.05). The children with a cord 25(OH)D level <30 nmol/L showed a significantly higher incidence of AD than those with a cord 25(OH)D level ≥30 nmol/L (P<0.05). The receiver operating characteristic (ROC) analysis showed that the area under the ROC curve of cord 25(OH)D in predicting AD was 0.648 (standard error: 0.075; 95%CI: 0.502-0.795). Its sensitivity, specificity, positive predictive value, and negative predictive value were 52.2%, 79.5%, 57.1%, and 76.1%, respectively. Logistic regression analysis showed that low cord 25(OH)D level, preference for seafood during pregnancy, atopic family history, and mixed feeding were risk factors for infantile AD (P<0.05).

CONCLUSIONSCord 25(OH)D level is inversely associated with the risk of infantile AD, but it has a low diagnostic value for this disease.

Calcifediol ; blood ; Dermatitis, Atopic ; blood ; epidemiology ; etiology ; prevention & control ; Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Predictive Value of Tests ; ROC Curve ; Risk Factors

This short-term, prospective study was aimed to assess the effects of partially hydrolyzed formula (PHF) on the prevention of the development of atopic dermatitis in infants at high risk. The infants of parents with allergy symptoms and serum total IgE over 200 kU/L were divided into 3 groups by their feeding patterns: PHF group (n=15), standard formula (SF) group (n=32), and breast milk (BM) group (n=22). No allergenic food was given during the study period of 6 months, and breastfeeding mothers avoided egg ingestion. Their atopic symptoms were monitored every 2 months. The cumulative incidence and prevalence of atopic dermatitis at the age of 6 months were significantly less in the PHF group than in the SF group (47% vs.78%, p<0.05; 20% vs. 59%, p<0.05). Those rates of the PHF group were also less than those of the BM group, but they were not statistically significant. There was no difference in the onset age and disease severity. These results suggest that early feeding of PHF to infants at high risk has a short-term preventive effect on the development of atopic dermatitis during the first 6 months of life. Long-term preventive effects should be evaluated.
Breast Feeding ; Dermatitis, Atopic/*etiology/*prevention & control ; Electrophoresis, Polyacrylamide Gel ; Female ; Food Hypersensitivity ; Human ; Hydrolysis ; Hypersensitivity ; Immunoglobulin E/blood ; Infant ; *Infant Food ; Infant, Newborn ; Male ; Milk, Human ; Prospective Studies ; Protein Hydrolysates/*therapeutic use ; Risk ; Time Factors

OBJECTIVETo assess the preventive effects of different dietary regimens on development of eczema and food allergy in infants at high-risk for allergy.

METHODSForty-six infants whose parents were atopic and umbilical cord IgE > 0.35 kU/L were enrolled in the study. The infants were randomly assigned at birth to one of 2 dietary regimen protocols: those in intervention group (23 cases) were breast fed till more than 4 months of age, then followed by feeding with partially hydrolyzed formula (pHF), combined solid foods avoidance until 4-month of age, egg, fish, shrimp avoidance until 12-month of age. The other 23 cases in non-intervention group were breast fed for less than 4 months, or bottle fed with cow's milk-based formula, egg yolk was introduced at 4-month of age, and egg white at 6-month of age, besides, no any other dietary avoidance was applied. All the infants were followed-up for 18 months. The primary end point was the presence of atopic eczema. Food allergy was detected by fresh food prick-to-prick tests or in vitro sIgE or Fx5E.

RESULTSAt 6 months, 12 months and 18 months, the incidence of eczema in intervention group was 4.3% (1/23), 8.7% (2/23), and 17.4% (4/23), respectively, which was significantly reduced as compared to that of the non-intervention group, which was 26.1% (6/23), 34.8% (8/23), and 39.1% (9/23), respectively. Food allergy was found in 13.0% (3/23) of intervention group and 34.8% (9/23) of non-intervention group by skin prick tests or sIgE. Egg white was the most common offending food.

CONCLUSIONEarly life dietary interventions which included breastfeeding, delayed solid food introducing, pHF feeding, and high risk food avoidance could reduce the risk of atopic eczema and food allergy development, and was probably an effective primary intervention method for infants at high risk for atopy.

Breast Feeding ; Dermatitis, Atopic ; diet therapy ; epidemiology ; etiology ; prevention & control ; Female ; Fetal Blood ; immunology ; Follow-Up Studies ; Food Hypersensitivity ; complications ; diet therapy ; epidemiology ; Humans ; Immunoglobulin E ; blood ; Infant ; Infant Formula ; methods ; Infant, Newborn ; Male ; Mothers ; Prevalence ; Risk Factors ; Time Factors ; Treatment Outcome