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.