Abstract
BackgroundNon-communicable diseases, such as allergies, are influenced by both genetic and epigenetic factors. Perinatal determinants conceivably modify the epigenetic makeup of the developing fetal immune system preventing or predisposing the development of allergies. The aim of this study therefore was to identify independent perinatal factors associated with allergic sensitization in childhood.MethodsIn a single center retrospective case-cohort study electronic obstetric medical records and available skin prick testing results of children were analyzed. For the analysis 286 skin prick test positive (sensitized) children [median (IQR): 3.47 (1.70–7.34) years] were compared with data from all remaining live births in the obstetric cohort (n = 66,583).ResultsSensitized children more frequently had a mother born in Asia (19.1% vs. 10.2%; P < 10–6). Applying backward elimination logistic regression, seven out of 23 initially entered perinatal factors remained in the model. High maternal age (> 35 years; OR: 1.912; P < 0.001), male offspring sex (OR: 1.423; P < 0.01) and assisted conception (OR: 1.771; P < 0.05) increased the risk for allergic sensitization. In contrast, maternal smoking (OR: 0.469; P < 0.005), increasing parity (OR: 0.881; P < 0.05), maternal pre-pregnancy overweight (OR: 0.742; P < 0.005) and preterm birth (OR: 0.484; P < 0.05) decreased the risk for allergic sensitization.ConclusionsIn addition to supporting previous findings, this study is first to report an increased risk of allergic sensitization after assisted conception. Beyond this finding’s potential implementation in preventative strategies, exploration of this association could further pathophysiological understanding of allergic disease.
Highlights
Affecting around 30–40% of the world’s population, allergies are the most common and earliest-onset noncommunicable diseases [1]
Anthropometric measurements As birth weight, length and head circumference (HC) are naturally confounded by gestational age and sex, z-scores were used for further analysis
Aside from strengthening the association of previously suggested risk factors of allergic sensitization, one novel perinatal factor was found to have an effect on childhood atopy, namely assisted conception
Summary
Affecting around 30–40% of the world’s population, allergies are the most common and earliest-onset noncommunicable diseases [1]. The pathogenesis of allergic disease remains unclear. Even though the importance of a hereditary component is well established, there is considerable evidence that the effect of family history partly reflects shared environmental risk factors [3]. Fetal adaptation comes with the risk of a mismatch between the predicted and the actual encountered environment and is assumed to contribute to the development of allergic disease [5, 6]. Non-communicable diseases, such as allergies, are influenced by both genetic and epigenetic factors. Perinatal determinants conceivably modify the epigenetic makeup of the developing fetal immune system preventing or predisposing the development of allergies. The aim of this study was to identify independent perinatal factors associated with allergic sensitization in childhood
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