TOPLINE:

Atopic dermatitis (AD) in childhood was not associated with meaningfully diminished academic performance among adolescents in cohort studies from Denmark and England involving 782,837 children.

METHODOLOGY:

• To investigate the association between AD and academic performance, researchers conducted parallel population-based cohort studies in Denmark and England, including 782,837 children (776,214 from Denmark and 6623 from England).
• AD exposure was defined using hospital diagnoses before age 13 years in Denmark and two or more maternal reports by age 11.5 years in England.
• Study outcomes were nonpassing grades and mean academic performance scores.
• Danish analyses were repeated in exposure-discordant full siblings (total 14,160 children; 6351 with AD) to account for shared family factors such as socioeconomic position, family structure, and genetic and early environmental factors.

TAKEAWAY:

• In Denmark, the fully adjusted mean difference in academic performance scores was -0.06 points (95% CI, -0.11 to -0.01) for children with AD vs without AD, which was negligible considering the grading scale.
• Children with vs without active AD in Denmark had a similar prevalence of nonpassing grades (12.0% vs 11.2%; adjusted prevalence ratio [aPR], 1.06; 95% CI, 1.01-1.12), but the findings were inconsistent across outcomes and settings.
• In England, children with vs without AD had a lower prevalence of nonpassing grades (37.7% vs 47.4%; aPR, 0.88; 95% CI, 0.83-0.93) and higher mean performance scores (fully adjusted mean difference, 10.48 points; 95% CI, 6.49-13.86).
• Phenotype-specific analyses in England showed that the differences in performance were primarily driven by an association among those with moderate-declining AD (aPR, 0.84; 95% CI, 0.77-0.92) and moderate-frequent AD (aPR, 0.88; 95% CI, 0.80-0.98), whereas mild-intermittent and severe-frequent AD showed no significant differences from unaffected children.

IN PRACTICE:

“The parallel studies’ results are reassuring for clinicians, educators, and families, and do not support routine expectations of academic underperformance due to AD among adolescents taking national compulsory examinations,” the authors of the study wrote. “Nevertheless,” they added, “because children with AD may experience symptoms interfering with concentration, sleep, or participation, a tailored, needs-based approach remains important to improve quality of life.”

SOURCE:

The study was led by Rita J. Iskandar, MD, MSc, London School of Hygiene & Tropical Medicine, London, England, and was published online on April 8 in JAMA Dermatology.

LIMITATIONS:

The study limitations included potential selection bias, missing data, and residual confounding.

DISCLOSURES:

This study received support from Said Foundation, the Academy of Medical, Wellcome Trust, the Aase and Ejnar Danielsens Fund, and the Dagmar Marshalls Foundation. Iskandar disclosed receiving a scholarship from Said Foundation and Fellowship from the Academy of Medical Sciences Several other authors being employed or receiving personal fees, grants, and awards from various drug companies and institutions, including Amgen, Apogee, Astria, Incyte, Medidata, Nektar Therapeutics, Sanofi, and Pfizer. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.