Allergic multimorbidity of asthma, rhinitis, and eczema over 20 years in the German birth cohort MAS


  • H. Gough
  • L. Grabenhenrich
  • A. Reich
  • N. Eckers
  • O. Nitsche
  • D. Schramm
  • J. Beschorner
  • U. Hoffmann
  • A. Schuster
  • C.P. Bauer
  • J. Forster
  • F. Zepp
  • Y.A. Lee
  • R.L. Bergmann
  • K.E. Bergmann
  • U. Wahn
  • S. Lau
  • T. Keil


  • Pediatric Allergy and Immunology


  • Pediatr Allergy Immunol 26 (5): 431-437


  • Background: The occurrence of allergic multimorbidity (coexistence of asthma, allergic rhinitis and eczema) has not been evaluated longitudinally from early childhood up to adulthood in a population-based study sample. We aimed to determine the prevalence of allergic multimorbidity up to age 20 stratified by parental allergies and sex/gender using extensive prospective follow-up data from two decades of a birth cohort study. Methods: In 1990, we recruited 1314 healthy newborns from 6 maternity wards across Germany for the population-based MAS birth cohort study. The sample was purposely risk-enriched by increasing the proportion of children at high allergy-risk (i.e. at least 2 allergic family members among parents and siblings) from 19% in the source population to 38% in the final sample. The remaining 62% of all MAS children had a low or no allergy risk. Symptoms, medication and doctor's diagnoses of allergic diseases have been assessed using standardised questionnaires including validated ISAAC questions in 19 follow-up assessments up to age 20. Allergic multimorbidity at each time point was defined as the coexistence of at least 2 of the following diseases in one participant: asthma, allergic rhinitis, eczema. Results: Response at age 20 was 72% (n=942) of all recruited participants. At age 20, 18.5% (95%-CI 15.0-22.5%) of all participants with allergic parents had 2 or 3 concurrent allergies as compared to only 6.3% (95%-CI 4.3-9.0%) of those with non-allergic parents. At this age, allergic multimorbidity was similar in females and males (12.7% (95%-CI 9.7-16.2%) vs. 11.6% (95%-CI 8.9-14.8%)); whereas single allergic diseases were more common in women than men (24.2% (95%-CI 20.2-28.5%) vs. 20.1% (95%-CI 16.6-24.0%)). Asthma occurred more frequently with coexisting allergic rhinitis and/or eczema than as a single entity from pre-puberty to adulthood. Conclusion: Having parents with allergies is not only a strong predictor to develop any allergy but it strongly increases the risk of developing allergic multimorbidity. In males and females alike, co-existing allergies were increasingly common throughout adolescence up to adulthood. Particularly asthma occurred in both sexes more frequently with co-existing allergies than as a single entity.