Background: Eczema in early childhood is associated with
developing subsequent allergic diseases, including food allergy, asthma
and hay fever. However, eczema has a heterogenous presentation regarding
age of onset and persistence, which may lead to different allergic
outcomes during childhood/adolescence. Recently, sub-phenotypes of
eczema have been suggested as predictor for allergic multimorbidity.
Objective: To identify associations of eczema phenotypes
with food allergy, asthma and hay fever during childhood/adolescence.
Additionally, we aimed to describe the trajectories of eczema, asthma
and hay fever, stratifying by food allergy presence.
Methods: TRACKER (Trajectories of Allergy in Children in
Real Life Databases) is a prospective cross-sectional population-based
cohort study of 6,852 children/adolescents from the Lifelines cohort. We
investigated associations of seven eczema phenotypes, based on age of
onset and persistence, with food allergy, asthma and hay fever using
logistic regression, adjusted for appropriate covariates. Disease
trajectories were determined by calculating prevalence at different
ages. Results: Participants who suffered from eczema
throughout childhood showed higher risks of developing food allergy, hay
fever and asthma. “Very early onset – persistent” eczema showed the
strongest associations with food allergy, asthma and hay fever. The
prevalence of eczema, asthma and hay fever at all ages were
significantly higher in participants with food allergy, compared to
those without. Conclusion: The largest cohort study on
this topic to date shows that (very) early onset and persistent eczema
increases the risk for allergic multimorbidity. Identification of
infants at risk for developing (very) early onset eczema is of utmost
importance to prevent allergic multimorbidity.