A protective influence of maternal inflammatory status on infantile atopic eczema risk has been proposed, but few studies have investigated these potential links. We examined the associations between energy-adjusted dietary inflammatory index (E-DII) scores indicative of an inflammatory dietary pattern, maternal serum neopterin levels, a biomarker elevated in Th1 immune activation, and infantile risk of atopic eczema. Within the UK Southampton Women’s Survey, mothers’ diets were recorded using questionnaires at preconception, early and late pregnancy and E-DII scores derived. Atopic eczema was ascertained using the UK Working Party Diagnostic Criteria at ages 6 and 12 months (n=2955 and 2871, respectively). A sub-sample of 497 mothers had serum neopterin measured in late pregnancy. Unadjusted analyses showed that higher E-DII in preconception and late pregnancy was associated with a lower risk of eczema at ages 6 and 12 months. After adjusting for maternal BMI, age, parity, education, smoking during pregnancy, breastfeeding duration and sex, higher E-DII in late pregnancy was associated with reduced risks of eczema at age 6 and 12 months (OR 0.89 [95%CI 0.81,0.99], p=0.03 and OR 0.91 [0.82,1.00], p=0.05, respectively). Consistent with this, higher maternal serum neopterin was associated with a lower risk of eczema at ages 6 months (OR 0.72 (0.51,1.01), p=0.05) and 12 months (OR 0.71 (0.53,0.96), p=0.03). The findings suggest that a pro-inflammatory maternal diet and an inflammatory maternal environment during pregnancy may protect the developing infant from Th2 driven inflammation and lower the risk of infantile atopic eczema.

Background: Infants with atopic dermatitis (AD) are reported to be at higher risk of early childhood caries (ECC) at 3-years, but the clinical validity of the reported link remains unknown. We investigated if clinical severity of AD in young children is associated with increased ECC risk at 3-years. Methods: In Growing Up in Singapore Towards healthy Outcomes (GUSTO) mother-offspring cohort, AD was diagnosed by trained physicians using Hanifin and Rajka criteria at 18-month and 3-year clinic visits (n=837). Of the children diagnosed with AD, disease severity was assessed using SCORAD (SCORing Atopic Dermatitis) index and categorized into moderate-to-severe AD (SCORAD≥25), and mild AD (SCORAD<25), with children without AD (non-AD) as a reference group. Oral examinations for ECC detection was performed by calibrated dentists in 656 children at age 3-years. Negative binomial regression was used to calculate the adjusted incidence risk ratio (aIRR; adjusted for socio-demographic factors and prenatal tobacco smoke exposure). Results: Atopic dermatitis was diagnosed in 7.3% (61/837) children; amongst which 23% had moderate-to-severe AD and 77% had mild AD. ECC was observed in 85.7%, 36.8% and 42.8% of the children in moderate-to-severe, mild and non-AD groups, respectively. Children with moderate-to-severe AD were at higher risk of ECC (aIRR 2.30 [95% confidence interval (CI) 1.04-5.06]; p=0.03) at 3 years compared to non-AD, while no association was seen between mild AD and ECC. Conclusions: Children with moderate-to-severe atopic dermatitis were at higher risk of ECC compared to those without AD and may benefit from early dental referral.