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Atopic dermatitis (AD) is a chronic inflammatory skin condition predominantly affecting children, and emerging evidence suggests a potential association with inflammatory bowel disease (IBD). This systematic review and meta-analysis aimed to quantify the risk of developing IBD, Crohn's disease (CD), and ulcerative colitis (UC) in children with AD compared with those without. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted from inception to June 2025. Cohort and case-control studies involving children aged 0-18 years with a diagnosis of AD and reporting IBD as an outcome were eligible for inclusion. Study quality was assessed using the Newcastle-Ottawa Scale, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Four studies were included in the meta-analysis. Pooled analysis demonstrated that children with AD had a significantly increased risk of IBD compared with controls (OR: 1.44; 95% CI: 1.26-1.64), with substantial heterogeneity across studies (I² = 70%). Subgroup analyses revealed elevated risks for both CD (OR: 1.46; 95% CI: 1.13-1.90) and UC (OR: 1.27; 95% CI: 1.02-1.59). Leave-one-out sensitivity analysis confirmed the stability and robustness of these findings. In conclusion, children with AD are at a significantly increased risk of developing IBD, highlighting the need for heightened clinical awareness of gastrointestinal comorbidities in this population and warranting further prospective paediatric research.
Loiacono et al. (Wed,) studied this question.