Background Pediatric atopic dermatitis (AD) is closely linked to the subsequent development of food allergy, asthma, and rhinitis. It is currently unknown if the association is influenced by birth maturity. Objectives To investigate the occurrence of AD, food allergy, asthma, and rhinitis in term and preterm children from birth to age 4-5 years. Methods A prospective birth cohort of 389 children (261 term, 128 preterm) was followed from birth to 4–5 years. Results The overall prevalence of AD was 29.6% at age 2 years and 33.0% at 4-5 years. Preterm children had a lower prevalence of AD (19.2% vs. 39.8%, p < 0.0001), later AD onset (median 12.0 vs. 7.5 months, p < 0.01), milder disease severity (median EASI 1.4 vs. 4.8, p < 0.01), and less persistent AD (11.5% vs. 19.9%, p < 0.0001) than term children. Among children born preterm and term, the prevalence of food allergy, asthma, and rhinitis at ages 4-5 years was 1.6% vs. 3.1%, 20.0% vs. 13.0%, and 6.2% vs. 4.6%, respectively. No preterm children with AD (n=25) developed food allergies within 4–5 years compared to 6.7% among term born children, whereas asthma prevalence was higher among preterm children with AD (36.0%) compared to term children with AD (17.3%) (p=0.05). Conclusion Prematurely born children have a conspicuously reduced risk of AD, with later onset and a milder and less persistent disease course. Prematurely born children had significantly different epidemiology of food allergy and asthma compared to term born children.