Pre-natal folic acid and iron supplementation and atopic dermatitis in the first 6 years of life

  • Cristina FortesEmail author
  • Simona Mastroeni
  • Thomas J. Mannooranparampil
  • Domenico Di Lallo
Original Paper


Exposure in utero has been suggested to influence health later in life. The aim of this study was to investigate, if the use of prenatal food supplements was associated with atopic dermatitis in the offspring. Mothers who gave birth in the hospital G. B. Grassi were invited to participate in the study (n = 395). Information on socio-demographic characteristics, clinical data of the mothers and babies, vegetables and fruit intake, food avoidance, and food supplements use during pregnancy, depression status, and environmental exposure was obtained for all subjects in the hospital at the time of delivery. Data on breastfeeding practice, introduction of weaning foods, day care attendance, and atopic dermatitis were collected in the postnatal follow-ups. Logistic regression was applied to estimate odds ratio (OR) and 95% confidence intervals (CI). Children in which mothers used both iron and folic acid supplementation had a fourfold decreased risk of developing atopic dermatitis [OR = 0.22; 95% confidence interval (CI) 0.06–0.79, p = 0.02], after adjusting for possible confounding factors. Findings suggest an independent and protective effect of prenatal folic acid and iron supplementation for atopic dermatitis in children.


Atopic dermatitis Risk factors Folic acid and iron supplementation 



This work was supported by the Lazio Regional Health Authority and by the Progetto di Ricerca 4.2, Atopic Dermatitis, Italian Ministry of Heath, 2018.

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflicts of interest to disclose.

Informed consent

Informed consensus was obtained from all participants of the study.


  1. 1.
    Begin P, Nadeau KC (2014) Epigenetic regulation of asthma and allergic disease. Allergy Asthma Clin Immunol 10:27. CrossRefGoogle Scholar
  2. 2.
    Brunner PM, Silverberg JI, Guttman-Yassky E, Paller AS, Kabashima K, Amagai M, Luger TA, Deleuran M, Werfel T, Eyerich K, Stingl G (2017) Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol 137:18–25. CrossRefGoogle Scholar
  3. 3.
    Chandra RK (1997) Nutrition and the immune system: an introduction. Am J Clin Nutr 66:460S–463SCrossRefGoogle Scholar
  4. 4.
    Crider KS, Cordero AM, Qi YP, Mulinare J, Dowling NF, Berry RJ (2013) Prenatal folic acid and risk of asthma in children: a systematic review and meta-analysis. Am J Clin Nutr 98:1272–1281. CrossRefGoogle Scholar
  5. 5.
    Cunningham-Rundles S, McNeeley DF, Moon A (2005) Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 115:1119–1128. (quiz 1129) CrossRefGoogle Scholar
  6. 6.
    Deckers IA, McLean S, Linssen S, Mommers M, van Schayck CP, Sheikh A (2012) Investigating international time trends in the incidence and prevalence of atopic eczema 1990–2010: a systematic review of epidemiological studies. PLoS One 7:e39803. CrossRefGoogle Scholar
  7. 7.
    Dom S, Droste JH, Sariachvili MA, Hagendorens MM, Oostveen E, Bridts CH, Stevens WJ, Wieringa MH, Weyler JJ (2010) Pre- and post-natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years. Clin Exp Allergy 40:1378–1387. CrossRefGoogle Scholar
  8. 8.
    Dunstan JA, West C, McCarthy S, Metcalfe J, Meldrum S, Oddy WH, Tulic MK, D’Vaz N, Prescott SL (2012) The relationship between maternal folate status in pregnancy, cord blood folate levels, and allergic outcomes in early childhood. Allergy 67:50–57. CrossRefGoogle Scholar
  9. 9.
  10. 10.
    Irvine AD, McLean WH, Leung DY (2011) Filaggrin mutations associated with skin and allergic diseases. N Engl J Med 365:1315–1327. CrossRefGoogle Scholar
  11. 11.
    Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, Nsoesie EO, Ferrari AJ, Erskine HE, Silverberg JI, Vos T, Naghavi M (2017) Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol 153:406–412. CrossRefGoogle Scholar
  12. 12.
    Kim JH, Jeong KS, Ha EH, Park H, Ha M, Hong YC, Bhang SY, Lee SJ, Lee KY, Lee SH, Kim Y, Kim MH, Chang N (2015) Relationship between prenatal and postnatal exposures to folate and risks of allergic and respiratory diseases in early childhood. Pediatr Pulmonol 50:155–163. CrossRefGoogle Scholar
  13. 13.
    Lindau JF, Mastroeni S, Gaddini A, Di Lallo D, Fiori Nastro P, Patane M, Girardi P, Fortes C (2015) Determinants of exclusive breastfeeding cessation: identifying an “at risk population” for special support. Eur J Pediatr 174:533–540. CrossRefGoogle Scholar
  14. 14.
    Magdelijns FJ, Mommers M, Penders J, Smits L, Thijs C (2011) Folic acid use in pregnancy and the development of atopy, asthma, and lung function in childhood. Pediatrics 128:e135–e144. CrossRefGoogle Scholar
  15. 15.
    Maggini S, Wintergerst ES, Beveridge S, Hornig DH (2007) Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br J Nutr 98(Suppl 1):S29–S35. Google Scholar
  16. 16.
    Oh SY, Chung J, Kim MK, Kwon SO, Cho BH (2010) Antioxidant nutrient intakes and corresponding biomarkers associated with the risk of atopic dermatitis in young children. Eur J Clin Nutr 64:245–252. CrossRefGoogle Scholar
  17. 17.
    Omara FO, Blakley BR (1994) The effects of iron deficiency and iron overload on cell-mediated immunity in the mouse. Br J Nutr 72:899–909CrossRefGoogle Scholar
  18. 18.
    Richmond RC, Sharp GC, Herbert G, Atkinson C, Taylor C, Bhattacharya S, Campbell D, Hall M, Kazmi N, Gaunt T, McArdle W, Ring S, Davey Smith G, Ness A, Relton CL (2018) The long-term impact of folic acid in pregnancy on offspring DNA methylation: follow-up of the Aberdeen Folic Acid Supplementation Trial (AFAST). Int J Epidemiol. Google Scholar
  19. 19.
    Weidinger S, Novak N (2016) Atopic dermatitis. Lancet 387:1109–1122. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Cristina Fortes
    • 1
    Email author
  • Simona Mastroeni
    • 1
  • Thomas J. Mannooranparampil
    • 1
  • Domenico Di Lallo
    • 2
  1. 1.Epidemiology UnitIstituto Dermopatico dell’Immacolata (IDI-IRCCS)RomeItaly
  2. 2.Lazio Regional Health AuthorityRomeItaly

Personalised recommendations