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Meconium‐stained amniotic fluid as a protective factor against childhood dermatitis and skin rash‐related hospitalization in the offspring – a population‐based cohort analysis
Author(s) -
Krieger Y.,
Horev A.,
Wainstock T.,
Sheiner E.,
Walfisch A.
Publication year - 2020
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15881
Subject(s) - medicine , rash , atopic dermatitis , hazard ratio , population , cohort study , proportional hazards model , cohort , obstetrics , dermatology , confidence interval , environmental health
Background Gut microbiome influences cutaneous diseases including atopic dermatitis. Possible impact of intrauterine exposure to meconium on the occurrence of dermatitis and skin rash was proposed. Objective We investigated the possible influence of intrauterine exposure to meconium‐stained amniotic fluid ( MSAF ) on the occurrence of dermatitis and skin rash‐related hospitalizations throughout childhood. Methods Singleton deliveries occurring between 1991 and 2014 at a single medical centre were divided into two study groups based on presence or lack of MSAF during delivery. Population‐based cohort analysis, Kaplan–Meier survival analysis and Cox proportional hazards model were used to study the association between MSAF and cutaneous morbidity‐related hospitalizations. Results A lower rate of the total dermatitis or skin eruption‐related hospitalization was documented in the MSAF ‐exposed group; 0.78 per 1000‐person years (0.9%, n = 312), as compared to 0.98 per 1000‐person years in the unexposed group (1.0%, n = 1992) with a hazard ratio of 0.86 (95% CI 0.76‐0.96, P = 0.011). The survival curve showed lower cumulative hospitalization rate in the MSAF ‐exposed group as compared to the unexposed group (log rank P = 0.01). The Cox analysis, controlled for confounders, demonstrated MSAF exposure to be an independent protective factor for dermatitis and skin rash‐related hospitalizations during childhood (adjusted HR 0.878 (95% CI 0.779‐0.990, P = 0.034). Conclusion Fetal exposure to MSAF appears to be an independent protective factor for dermatitis and skin rash‐related hospitalizations in the offspring throughout childhood and adolescence.