Strengths and limitations
It is a major strength of the study that this is a prospective
mother-child cohort design with 19 planned visits up until 12 years of
age all including evaluations of AD at the COPSAC research
clinic11,15,16. Moreover, all children were
additionally seen at the COPSAC clinic at acute visits for any
skin-related symptoms, which minimized the risk of parental recall bias
and ensured we captured the highest SCORAD values during the children’s
disease course. All AD diagnoses strictly followed standard operating
procedures. This careful prospective follow-up is a significant strength
enabling accurate diagnosis of AD including severity (SCORAD).
Another strength is the measurement of the outcomes, aeroallergen
sensitization and allergic rhinitis, at two time-points (6-7 and 12
years), which ensured conclusions based on results from both early
school-age and early teens.
All mothers had a history of asthma, i.e. study participants were at
risk of respiratory allergy and asthma, which may limit the
generalizability of our findings.