Background: As there is a scarcity of evidence on potential hazards and preventive factors for infantile eczema operating in the prenatal period, the main goal of this study was to assess the role of prenatal exposure to fine particulate matter and environmental tobacco smoke (ETS) in the occurrence of infant eczema jointly with the possible modulating effect of maternal fish consumption. Methods: The study sample consisted of 469 women enrolled during pregnancy, who gave birth to term babies (>36 weeks of gestation). Among all pregnant women recruited, personal measurements of fine particulate matter (PM2.5) were performed over 48 h in the second trimester of pregnancy. After delivery, every 3 months in the first year of the newborn’s life, a detailed, standardized, face-to-face interview was administered to each mother, in the process of which a trained interviewer recorded any history of infantile eczema and data on potential environmental hazards. The estimated risk of eczema related to higher prenatal exposure to fine particulate matter (PM2.5 >53.0 µg/m3) and postnatal ETS as well as the protective effect of maternal fish intake were adjusted for potential confounders in a multivariable logistic regression model. Results: While the separate effects of higher prenatal PM2.5 and postnatal ETS exposure were not statistically significant, their joint effect appeared to have a significant influence on the occurrence of infantile eczema [odds ratio 2.39, 95% confidence interval (CI) 1.10–5.18]. With maternal fish intake of more than 205 g/week, the risk of eczema decreased by 43% (odds ratio 0.57, 95% CI 0.35–0.93). The incidence rate ratio (IRR) for eczema symptoms, estimated from the Poisson regression model, was increased with both higher exposure to prenatal PM2.5 and postnatal ETS (IRR 1.55, 95% CI 0.99–2.44) and in children of atopic mothers (IRR 1.35, 95% CI 1.04–1.75) but was lower in girls (IRR 0.78, 95% CI 0.61–1.00). The observed preventive effect of fish consumption on the frequency of eczema symptoms was consistent with the results of the logistic analysis (IRR 0.72, 95% CI 0.52–0.99). Conclusions: The findings indicate that higher prenatal exposure to fine particulate matter combined with postnatal exposure to ETS may increase the risk of infant eczema, while maternal fish intake during pregnancy may reduce the risk of infantile eczema.

Keywords:
Fish consumption, Prenatal exposure to fine particles, Cow’s milk allergy, Passive tobacco smoke, Cohort study
1.
Williams HC: Epidemiology of atopic dermatitis. Clin Exp Dermatol 2000;25:522–529.
2.
Wadonda-Kabondo N, Sterne JA, Golding J, Kennedy CT, Archer CB, Dunnill MG; ALSPAC Study Team: A prospective study of the prevalence and incidence of atopic dermatitis in children aged 0–42 months. Br J Dermatol 2003;149:1023–1028.
3.
Asher MI, Montefort S, Björkstèn B, Lai CK, Strachan DP, Weiland SK, Williams H; ISAAC Phase Three Study Group: Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeated multicountry cross-sectional surveys. Lancet 2006;368:733–743.
4.
Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG: The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol 1994;30:35–39.
5.
Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U; Multicenter Allergy Study Group: The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol 2004;113:925–931.
6.
Spergel JM, Paller AS: Atopic dermatitis and the atopic march. J Allergy Clin Immunol 2003;112(6 suppl):S118–S127.
7.
Bergmann RL, Edenharter G, Bergmann KE, Forster J, Bauer CP, Wahn V, Zepp F, Wahn U: Atopic dermatitis in early infancy predicts allergic airway disease at 5 years. Clin Exp Allergy 1998;28:965–970.
8.
Businco L, Falconieri P, Di Rienzo A, Bruno G: From atopic dermatitis to asthma: the risk factors and preventive measures. Pediatr Pulmonol Suppl 1997;16:19–20.
9.
van der Hulst AE, Klip H, Brand PL: Risk of developing asthma in young children with atopic eczema: a systematic review. J Allergy Clin Immunol 2007;120:565–569.
10.
Strachan DP: Time trends in asthma and allergy: ten questions, fewer answers. Clin Exp Allergy 1995;25:791–794.
11.
Krämer U, Sugiri D, Ranft U, Krutmann J, von Berg A, Berdel D, Behrendt H, Kuhlbusch T, Hochadel M, Wichmann HE, Heinrich J; GINIplus and LISAplus study groups: Eczema, respiratory allergies, and traffic-related air pollution in birth cohorts from small-town areas. J Dermatol Sci 2009;56:99–105.
12.
Bisgaard H, Halkjaer LB, Hinge R, Giwercman C, Palmer C, Silveira L, Strand M: Risk analysis of early childhood eczema. J Allergy Clin Immunol 2009;123:1355–1360.e5.
13.
Kjellman NI, Nilsson L: From food allergy and atopic dermatitis to respiratory allergy. Pediatr Allergy Immunol 1998;9(11 suppl):13–17.
14.
Krämer U, Weidinger S, Darsow U, Möhrenschlager M, Ring J, Behrendt H: Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol 2005;24:514–523.
15.
Lannerö E, Kull I, Wickman M, Pershagen G, Nordvall SL: Environmental risk factors for allergy and socioeconomic status in a birth cohort (BAMSE). Pediatr Allergy Immunol 2002;13:182–187.
16.
Sicherer SH, Sampson HA: Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol 1999;104:S114–S122.
17.
Gustafsson D, Sjöeberg O, Foucard T: Development of allergies and asthma in infants and young children with atopic dermatitis – a prospective follow-up to 7 years of age. Allergy 2000;55:240–245.
18.
Moore MM, Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Camargo CA Jr, Gold DR, Weiss ST, Gillman MW: Perinatal predictors of atopic dermatitis occurring in the first six months of life. Pediatrics 2004;113:468–474.
19.
Schäfer T, Dirschedl P, Kunz B, Ring J, Uberla K: Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring. J Am Acad Dermatol 1997;36:550–556.
20.
Böhme M, Wickman M, Lennart Nordvall S, Svartengren M, Wahlgren CF: Family history and risk of atopic dermatitis in children up to 4 years. Clin Exp Allergy 2003;33:1226–1231.
21.
Hanson L, Silfverdal SA, Strömbäck L, Erling V, Zaman S, Olcén P, Telemo E: The immunological role of breast feeding. Pediatr Allergy Immunol 2001;12(suppl 14):15–19.
22.
Goldman AS, Hopkinson JM, Rassin DK: Benefits and risks of breastfeeding. Adv Pediatr 2007;54:275–304.
23.
van Odijk J, Kull I, Borres MP, Brandtzaeg P, Edberg U, Hanson LA, Høst A, Kuitunen M, Olsen SF, Skerfving S, Sundell J, Wille S: Breastfeeding and allergic disease: a multidisciplinary review of the literature (1966–2001) on the mode of early feeding in infancy and its impact on later atopic manifestations. Allergy 2003;58:833–843.
24.
Kull I, Böhme M, Wahlgren CF, Nordvall L, Pershagen G, Wickman M: Breast-feeding reduces the risk for childhood eczema. J Allergy Clin Immunol 2005;116:657–661.
25.
Lowe AJ, Carlin JB, Bennett CM, Abramson MJ, Hosking CS, Hill DJ, Dharmage SC: Atopic disease and breastfeeding – cause or consequence? J Allergy Clin Immunol 2006;117:682–687.
26.
Sears MR, Greene JM, Willan AR, Taylor DR, Flannery EM, Cowan JO, Herbison GP, Poulton R: Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet 2002;360:901–907.
27.
Stulnig TM: Immunomodulation by polyunsaturated fatty acids: mechanisms and effects. Int Arch Allergy Immunol 2003;132:310–321.
28.
Dunstan J, Mori TA, Barden A, Beilin LJ, Taylor AL, Holt PG, Prescott SL: Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized controlled trial. J Allergy Clin Immunol 2003;112:1178–1184.
29.
Romieu I, Torrent M, Garcia-Esteban R, Ferrer C, Ribas-Fitó N, Antó JM, Sunyer J: Maternal fish intake during pregnancy and atopy and asthma in infancy. Clin Exp Allergy 2007;37:518–525.
30.
Jedrychowski W, Whyatt RM, Camann DE, Bawle UV, Peki K, Spengler JD, Dumyahn TS, Penar A, Perera FF: Effect of prenatal PAH exposure on birth outcomes and neurocognitive development in a cohort of newborns in Poland. Study design and preliminary ambient data. Int J Occup Med Environ Health 2003;16:21–29.
31.
Connor WE: Importance of n-3 fatty acids in health and disease. Am J Clin Nutr 2000;71 (1 suppl):171S–175S.
32.
Simopoulos AP: Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr 1991;54:438–463.
33.
Prescott SL, Calder PC: N-3 polyunsaturated fatty acids and allergic disease. Curr Opin Clin Nutr Metab Care 2004;7:123–129.
34.
Calder PC: N-3 polyunsaturated fatty acids and inflammation: from molecular biology to the clinic. Lipids 2003;38:343–352.
35.
Vachier I, Chanez P, Bonnans C, Godard P, Bousquet J, Chavis C: Endogenous anti-inflammatory mediators from arachidonate in human neutrophils. Biochem Biophys Res Commun 2002;290:219–224.
36.
Sanderson P, MacPherson GG, Jenkins CH, Calder PC: Dietary fish oil diminishes the antigen presentation activity of rat dendritic cells. J Leukoc Biol 1997;62:771–777.
37.
Calder PC, Miles EA: Fatty acids and atopic disease. Pediatr Allergy Immunol 2000;11(suppl 13):29–36.
38.
Duchén K, Björkstén B: Polyunsaturated n-3 fatty acids and the development of atopic disease. Lipids 2001;36:1033–1042.
39.
Calder PC: N-3 polyunsaturated fatty acids and cytokine production in health and disease. Ann Nutr Metab 1997;41:203–234.
40.
Spengler JD, Samet JM, McCarthy JF: Indoor Air Quality Handbook. New York, McGraw-Hill, 2001.
41.
Donaldson K, Stone V, Borm PJ, Jimenez LA, Gilmour PS, Schins RP, Knaapen AM, Rahman I, Faux SP, Brown DM, MacNee W: Oxidative stress and calcium signaling in the adverse effects of environmental particles (PM10). Free Radic Biol Med 2003;34:1369–1382.
42.
Wilhelm M, Ritz B: Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, 1994–1996. Environ Health Perspect 2003;111:207–216.
43.
Wood KA, Youle RJ: The role of free radicals and p53 in neuron apoptosis in vivo. J Neurosci 1995;15:5851–5857.
44.
Dejmek J, Solanský I, Benes I, Lenícek J, Srám RJ: The impact of polycyclic aromatic hydrocarbons and fine particles on pregnancy outcome. Environ Health Perspect 2000;108:1159–1164.
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