METHODS: In the Cohort for Childhood Origin of Asthma and Allergic Diseases, 470 infants were enrolled. Mold exposure was assessed using questionnaire. AD were assessed by pediatric allergists at ages 1 and 2. Trans-epidermal water loss (TEWL) were measured at age 1. The association between mold exposure and AD was assessed using Cox proportional hazards and logistic regression models.
RESULTS: Mold exposure during pregnancy increased the risk of AD (hazard ratio 1.49; 95% confidence intervals [CIs] 0.91-1.98) after adjustment for postnatal mold exposure. When infants were exposed to mold during fetal periods, hazard ratio for AD was increased as 2.43 (95% CI, 1.46-4.05) in infants with high levels of TEWL. Levels of total serum IgE levels at age 1 (P = 0.001) as well as log transformed IL-13/ IFN-γ from the cord blood (P = 0.005) were increased in infants exposed to mold during fetal life with higher levels of TEWL, compared to those without mold exposure and lower levels of TEWL.
CONCLUSIONS: Mold exposure during fetal life increases the risk of AD in early life, especially in infant with skin barrier dysfunction, through Th2 allergic inflammation.