Monika Calov1, Farzad Alinaghi1, Carsten Robert Hamann2, Jonathan Silverberg3, Alexander Egeberg1, Jacob Pontoppidan Thyssen4. 1. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark. 2. Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark; Section of Dermatology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH. 3. Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Ill. 4. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark. Electronic address: jacob.pontoppidan.thyssen@regionh.dk.
Abstract
BACKGROUND: Cold and dry climate negatively affects skin barrier functions. This could explain the higher incidence of atopic dermatitis (AD) in Northern countries distant from the equator, as well as the general worsening of AD in Northern European winter months. Although it has been suggested that fall and winter birth is associated with AD, this remains unknown. OBJECTIVES: To examine whether the prevalence of AD is associated with season of birth. METHODS: We conducted a systematic review and meta-analysis. Two reviewers independently searched 3 databases. Study quality was assessed using a Newcastle-Ottawa scale. Study heterogeneity was assessed with Cochrane Q and I2 statistics. Odds ratios with 95% CIs were calculated. Publication bias was assessed using funnel plots. RESULTS: The systematic review identified 23 relevant articles of which 9 articles were included in the meta-analysis. Among a total of 726,378 children aged 0 to 12 years, the overall pooled prevalence of AD was 12.9%. The pooled prevalence of AD was 15.4% (95% CI, 12.1%-19.1%), 14.9% (95% CI, 12.0%-18.1%), 12.7% (95% CI, 10.2%-15.4%), and 13.7% (95% CI, 10.8%-17.0%), among children born in the fall, winter, spring, and summer, respectively. AD was significantly associated with fall (odds ratio, 1.16; 95% CI, 1.06-1.28; P = .0018) and winter (odds ratio, 1.15; 95% CI, 1.04-1.27; P = .0076) birth compared with spring birth. CONCLUSIONS: Although a positive and significant association was observed between being born in fall and winter and developing AD on the Northern hemisphere, there is a need for additional and better-designed studies to understand the effect of seasonal changes on the risk of AD.
BACKGROUND: Cold and dry climate negatively affects skin barrier functions. This could explain the higher incidence of atopic dermatitis (AD) in Northern countries distant from the equator, as well as the general worsening of AD in Northern European winter months. Although it has been suggested that fall and winter birth is associated with AD, this remains unknown. OBJECTIVES: To examine whether the prevalence of AD is associated with season of birth. METHODS: We conducted a systematic review and meta-analysis. Two reviewers independently searched 3 databases. Study quality was assessed using a Newcastle-Ottawa scale. Study heterogeneity was assessed with Cochrane Q and I2 statistics. Odds ratios with 95% CIs were calculated. Publication bias was assessed using funnel plots. RESULTS: The systematic review identified 23 relevant articles of which 9 articles were included in the meta-analysis. Among a total of 726,378 children aged 0 to 12 years, the overall pooled prevalence of AD was 12.9%. The pooled prevalence of AD was 15.4% (95% CI, 12.1%-19.1%), 14.9% (95% CI, 12.0%-18.1%), 12.7% (95% CI, 10.2%-15.4%), and 13.7% (95% CI, 10.8%-17.0%), among children born in the fall, winter, spring, and summer, respectively. AD was significantly associated with fall (odds ratio, 1.16; 95% CI, 1.06-1.28; P = .0018) and winter (odds ratio, 1.15; 95% CI, 1.04-1.27; P = .0076) birth compared with spring birth. CONCLUSIONS: Although a positive and significant association was observed between being born in fall and winter and developing AD on the Northern hemisphere, there is a need for additional and better-designed studies to understand the effect of seasonal changes on the risk of AD.
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