Temporal trends of birthweight are not driving trends of atopic dermatitis prevalence in United States children


Population-based risk-factors for the rising prevalence of childhood atopic dermatitis (AD) in the United States are not well elucidated. We hypothesized that trends of birthweight over the past 2 decades contributed to the increasing prevalence of childhood AD in the United States. We sought to determine whether trends of birthweight were associated with trends of childhood AD prevalence over time in the US. Data were analyzed from the 1997–2018 National Health Interview Survey (N = 238,767 children). The prevalence [95% confidence interval] of childhood AD increased from 1997 (7.9% [7.4–8.5%]) to 2018 (12.6% [11.6–13.5%]). Whereas, mean [95% confidence interval] birthweight decreased from 1997 (3.35 kg [3.34–3.37 kg]) to 2018 (3.30 kg [3.28–3.31 kg]). A 1 kg increase in birthweight was associated with a slightly increased odds of AD (adjusted odds ratio [95% confidence interval] 1.039 [1.009–1.070]). However, there were no significant interactions between low or high birthweight and year as predictors of childhood AD prevalence overall or in any age group. In conclusion, there is a slight association between greater birthweights and AD prevalence. However, temporal trends of birthweight do not account for trends of childhood AD prevalence in the United States.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Asher MI, Montefort S, Bjorksten B et al (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 368(9537):733–743

    Article  Google Scholar 

  2. 2.

    Laughter D, Istvan JA, Tofte SJ, Hanifin JM (2000) The prevalence of atopic dermatitis in Oregon schoolchildren. J Am AcadDermatol 43(4):649–655

    CAS  Article  Google Scholar 

  3. 3.

    Schultz Larsen F, Hanifin JM (1992) Secular change in the occurrence of atopic dermatitis. Acta DermVenereolSuppl (Stockh) 176:7–12

    CAS  Google Scholar 

  4. 4.

    Panduru M, Salavastru CM, Panduru NM, Tiplica GS (2014) Birth weight and atopic dermatitis: systematic review and meta-analyis. ADC 22(2):91–96

    PubMed  Google Scholar 

  5. 5.

    Zhu T, Zhao J, Qu Y, Zhang L, Mu D (2018) Association of very preterm birth with decreased risk of eczema: a systematic review and meta-analysis. J Am AcadDermatol 78(6):1142-1148.e1148

    Article  Google Scholar 

  6. 6.

    Wooldridge AL, McMillan M, Marshall HS, Gatford KL (2016) Relationship between birth weight or fetal growth rate and postnatal allergy: a systematic review protocol. JBI Database Syst Rev Implement Rep 14(11):11–20

    Article  Google Scholar 

  7. 7.

    Silverberg JI, Patel N, Immaneni S et al (2015) Assessment of atopic dermatitis using self-report and caregiver report: a multicentre validation study. Br J Dermatol 173(6):1400–1404

    CAS  Article  Google Scholar 

  8. 8.

    Ferrandiz-Mont D, Wahyuniati N, Chen HJ, Mulyadi M, Zanaria TM, Ji DD (2018) Hygiene practices: are they protective factors for eczema symptoms? ImmunInflamm Dis 6(2):297–306

    CAS  Article  Google Scholar 

  9. 9.

    Kantor R, Silverberg JI (2017) Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol 13(1):15–26

    CAS  Article  Google Scholar 

  10. 10.

    Chandran U, Demissie K, Echeverria SE, Long JB, Mizan S, Mino J (2013) Food allergy among low birthweight children in a national survey. Matern Child Health J 17(1):165–171

    Article  Google Scholar 

  11. 11.

    Narla S, Silverberg JI (2020) The role of environmental exposures in atopic dermatitis. Curr Allergy Asthma Rep 20(12):74

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Jonathan I. Silverberg.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hou, A., Silverberg, J.I. Temporal trends of birthweight are not driving trends of atopic dermatitis prevalence in United States children. Arch Dermatol Res (2021). https://doi.org/10.1007/s00403-021-02188-0

Download citation


  • Epidemiology
  • Eczema
  • Dermatitis
  • Birthweight
  • Rash
  • Pruritus
  • Itch
  • Health