Forschungs- & Entwicklungsinformationsdienst der Gemeinschaft - CORDIS

Risk factors for development of childhood allergy as possible confounders in xenobiotic exposure

3.5 Predictors of childhood allergic disease (WP 1.3)

Background and Objective:
An increase in the prevalence of allergic diseases (AD) among children has been observed over the past two decades, especially in developed countries. Because the risk of developing AD is greater during infancy, it is important to identify antenatal and early-life predictors of AD. Data from recent studies indicate that elevated cord-blood (CB) immunoglobulin E (IgE) can be used as an early marker of AD among children. The aim of this study was to determine if there was an association between maternal AD status, antenatal exposures, and the level of CB IgE.

Methods:
Pregnant women were systematically recruited and interviewed from maternity hospitals in Belgium, Romania, and the Slovak Republic. Questionnaires were administered to each by local physicians. CB and maternal peripheral blood were analyzed for IgE levels and other markers. We stratified CB IgE levels into two outcome categories: = 0.35 kU/L (elevated) and <0.35 kU/L (normal). Univariate, stratified, and multivariate analysis were performed to measure the association between the maternal AD, antenatal exposures, and elevated level of CB IgE. The Mann-Whitney U-test was performed to assess the association between placental deposition with organochlorine compounds and level of CB IgE.

Results:
Among the total 788 mothers of the birthed cohort, the highest prevalence of maternal AD, excluding food allergy,existed in 66 (36%) of the 185 mothers from Belgium and the lowest in 25 (8%) of the 331 mothers from Romania. We observed the highest levels of CB IgE positivity among Romanian participants (38.9% in Bucharest and 32.6% in Giurgiu) and the lowest among Slovakian participants (15.3% in Stara Lubovna). Multivariate analysis did not reveal an association between maternal AD and elevated CB IgE (adjusted odds ratio [aOR]=1.1; 95% confidence interval [CI]= 0.45, 2.68). However, the presence of smokers at home (aOR=2.53; 95% CI=1.1, 5.9), and residence in a rural area during pregnancy (aOR= 4.5; 95% CI=1.33, 15.16) were associated with elevated CB IgE.

Conclusion:
While maternal AD (history of atopic diseases or history of food, drug, or insect allergy with elevated specific IgE) were not associated with elevated CB IgE, other modifiable antenatal predictors were found to be associated. Identification of these modifiable antenatal predictors of elevated CB IgE makes possible the implementation of prevention programs, like smoking cessation for pregnant women and household members of pregnant women.

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