Environmental and Lifestyle Determinants of Early-Life Atopic Dermatitis: A Narrative Review of Cord Blood IgE as a Predictive Marker

Background and Objectives: Atopic dermatitis (AD) frequently emerges in infancy and poses a considerable burden on families. Early identification of relevant risk factors is therefore essential. One potential biomarker is the cord blood immunoglobulin E (IgE), which may reflect prenatal sensitization and predisposition to allergic disorders. The present articles reviews and synthesizes evidence from studies published between 2014 and 2024 on the relationship between cord blood IgE and the risk of developing AD during the first year of life.

Key Findings: Most studies have shown that neonates with elevated cord blood IgE demonstrate a higher likelihood of experiencing AD within their initial year. Although reported effect sizes vary from modest to more pronounced, overall findings highlight that elevated cord blood IgE may signal heightened immune activation in utero. Genetic predisposition (e.g., parental atopy) and environmental exposures such as maternal smoking and pet contact frequently act as confounders or effect modifiers. Wide differences in IgE measurement techniques and cutoff thresholds, however, hamper direct comparisons among studies, necessitating greater standardization.

Conclusions: Elevated cord blood IgE indicates the possibility of using it as a marker to identify neonates at higher risk for atopic dermatitis. However, the clinical utility of cord blood IgE alone remains constrained by methodological heterogeneity and the multifactorial nature of AD. Future research may investigate carefully-refined measurement strategies by examining gene-environment interactions, and investigating preventative interventions. Also, cord blood IgE testing may become one component of a broader neonatal risk stratification framework to lessen early-onset allergic diseases.