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Early unselected emollient bathing is associated with subsequent atopic dermatitis in an observational cohort study
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  • Cathal O’Connor,
  • Vicki Livingstone,
  • Jonathan Hourihane,
  • Alan Irvine,
  • Geraldine Boylan,
  • Deirdre Murray
Cathal O’Connor
Cork University Hospital

Corresponding Author:[email protected]

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Vicki Livingstone
Cork University Hospital
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Jonathan Hourihane
Cork University Hospital
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Alan Irvine
University College Cork School of Medicine
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Geraldine Boylan
Cork University Hospital
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Deirdre Murray
Cork University Hospital
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Abstract

Background: Skin barrier dysfunction is a key component of the pathogenesis of atopic dermatitis (AD). Recent research on barrier optimization to prevent AD has shown mixed results. The aim of this study was to assess the relationship between emollient bathing at two months and the trajectory of AD in the first two years of life in a large unselected observational birth cohort study. Methods: The Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints Birth Cohort study enrolled 2183 infants. Variables extracted from the database related to early skincare, skin barrier function, parental history of atopy, and AD outcomes. Statistical analysis was performed to adjust for potential confounding variables. Results: 1,505 children had data on AD status available at six, 12, and 24 months. Prevalence of AD was 18.6% at six months, 15.2% at 12 months, and 16.5% at 24 months. Adjusted for potential confounding variables, the odds of AD at any point were higher among infants who had emollient baths at two months (OR (95% CI): 2.41 (1.56 to 3.72), p<0.001). Following multivariable analysis, the odds of AD were higher among infants who had both emollient baths and frequent emollient application at two months, compared to infants who had neither (OR (95% CI) at six months 1.74 (1.18-2.58), p=0.038), (OR (95% CI) at 12 months 2.59 (1.69-3.94), p<0.001), (OR (95% CI) at 24 months 1.87 (1.21-2.90), p=0.009). Conclusion: Early emollient bathing was associated with greater development of AD by two years of age in this unselected birth cohort study.
03 Nov 2022Submitted to Pediatric Allergy and Immunology
07 Nov 2022Submission Checks Completed
07 Nov 2022Assigned to Editor
07 Nov 2022Review(s) Completed, Editorial Evaluation Pending
08 Nov 2022Reviewer(s) Assigned
23 Dec 2022Editorial Decision: Revise Major
17 May 20231st Revision Received
22 May 2023Submission Checks Completed
22 May 2023Assigned to Editor
22 May 2023Review(s) Completed, Editorial Evaluation Pending
22 May 2023Reviewer(s) Assigned
08 Jun 2023Editorial Decision: Revise Major
21 Jun 20232nd Revision Received
21 Jun 2023Review(s) Completed, Editorial Evaluation Pending
21 Jun 2023Submission Checks Completed
21 Jun 2023Assigned to Editor
29 Jun 2023Editorial Decision: Accept