Nandini Mukherjee1, Thomas R Sutter2, Syed Hasan Arshad3,4,5, John W Holloway3,6, Hongmei Zhang1, Wilfried Karmaus1. 1. Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee. 2. Department of Biological Sciences, University of Memphis, Memphis, Tennessee. 3. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. 4. The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK. 5. NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK. 6. Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
Abstract
BACKGROUND: Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema. OBJECTIVE: Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence. METHODS: We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements. RESULTS: If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
BACKGROUND: Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema. OBJECTIVE: Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence. METHODS: We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements. RESULTS: If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
Authors: N J Elbert; E R van Meel; H T den Dekker; N W de Jong; T E C Nijsten; V W V Jaddoe; J C de Jongste; S G M A Pasmans; L Duijts Journal: Allergy Date: 2017-06-02 Impact factor: 13.146
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Authors: Bonnie R Joubert; Janine F Felix; Paul Yousefi; Kelly M Bakulski; Allan C Just; Carrie Breton; Sarah E Reese; Christina A Markunas; Rebecca C Richmond; Cheng-Jian Xu; Leanne K Küpers; Sam S Oh; Cathrine Hoyo; Olena Gruzieva; Cilla Söderhäll; Lucas A Salas; Nour Baïz; Hongmei Zhang; Johanna Lepeule; Carlos Ruiz; Symen Ligthart; Tianyuan Wang; Jack A Taylor; Liesbeth Duijts; Gemma C Sharp; Soesma A Jankipersadsing; Roy M Nilsen; Ahmad Vaez; M Daniele Fallin; Donglei Hu; Augusto A Litonjua; Bernard F Fuemmeler; Karen Huen; Juha Kere; Inger Kull; Monica Cheng Munthe-Kaas; Ulrike Gehring; Mariona Bustamante; Marie José Saurel-Coubizolles; Bilal M Quraishi; Jie Ren; Jörg Tost; Juan R Gonzalez; Marjolein J Peters; Siri E Håberg; Zongli Xu; Joyce B van Meurs; Tom R Gaunt; Marjan Kerkhof; Eva Corpeleijn; Andrew P Feinberg; Celeste Eng; Andrea A Baccarelli; Sara E Benjamin Neelon; Asa Bradman; Simon Kebede Merid; Anna Bergström; Zdenko Herceg; Hector Hernandez-Vargas; Bert Brunekreef; Mariona Pinart; Barbara Heude; Susan Ewart; Jin Yao; Nathanaël Lemonnier; Oscar H Franco; Michael C Wu; Albert Hofman; Wendy McArdle; Pieter Van der Vlies; Fahimeh Falahi; Matthew W Gillman; Lisa F Barcellos; Ashish Kumar; Magnus Wickman; Stefano Guerra; Marie-Aline Charles; John Holloway; Charles Auffray; Henning W Tiemeier; George Davey Smith; Dirkje Postma; Marie-France Hivert; Brenda Eskenazi; Martine Vrijheid; Hasan Arshad; Josep M Antó; Abbas Dehghan; Wilfried Karmaus; Isabella Annesi-Maesano; Jordi Sunyer; Akram Ghantous; Göran Pershagen; Nina Holland; Susan K Murphy; Dawn L DeMeo; Esteban G Burchard; Christine Ladd-Acosta; Harold Snieder; Wenche Nystad; Gerard H Koppelman; Caroline L Relton; Vincent W V Jaddoe; Allen Wilcox; Erik Melén; Stephanie J London Journal: Am J Hum Genet Date: 2016-03-31 Impact factor: 11.043