Prenatal exposure to bisphenol A (BPA) may affect fetal immune programming. This study aimed to examine associations between early BPA exposure and allergic diseases in the first 2 years in a prospective birth cohort. A total of 780 children completed at least one of the postnatal follow-ups at 6, 12, and 24 months (n = 697, 581, and 604, respectively). Atopic dermatitis (AD), food allergy, wheezing, and allergic rhinitis were diagnosed by pediatric dermatologists using ISAAC-standard questionnaires. Urinary BPA was measured in 620 mothers during late pregnancy and 463 children at the age of 24 months, detectable rate 98.8%, and 99.1%, respectively. The highest tertile (range: 3.2–304.4 μg/g creatinine) of maternal BPA was associated with lower odds of AD (OR = 0.48; 95% CI: 0.26–0.87) in the first 24 months, and a 0.27 lower log10 (serum total IgE, IU/mL) (95% CI: −0.49 to −0.05) at the age of 24 months compared to the low tertile (range: 0.2–1.7 μg/g creatinine). Children’s urinary BPA was also associated with lower odds of AD and lower serum IgE. Of note, infant antibiotic use was a factor associated with a higher risk of AD (OR = 1.99; 95% CI: 1.11–3.57) at the age of 24 months. Early BPA exposure was associated with lower AD incidence, suggesting its interference with the early immune system. Infant antibiotic use was associated with higher AD incidence.
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