Abstract
Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults. A follow-up was carried out in a Swedish birth cohort comprising 1,701 consecutively born children. In all, 1,661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1,227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32–34 years. Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up. In all, 49 out of 60 individuals with dispensed anti-inflammatory asthma medication at 32–34 years of age had not been reported having asthma at previous check-ups of the cohort during childhood. Among those, only 5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults. Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor in this long-time follow-up.
Highlights
Cord blood IgE (CB-IgE) as a possible predictor of asthma and allergy has been evaluated in a number of studies in recent years
Elevated CB-IgE-levels were significantly more common in males than in females in both groups (n = 1,227 and n = 1,661 with p = 0.009 and p = 001 respectively), and there was a significant difference in the register-linked group (n = 1,661) between the individuals with low CB-IgE compared to those with elevated CBIgE with respect to a family history of asthma (p = 0.039) and a history of asthma in the mother (p = 0.010) (Table 1)
5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults
Summary
Cord blood IgE (CB-IgE) as a possible predictor of asthma and allergy has been evaluated in a number of studies in recent years. These investigations have shown conflicting results [1,2,3,4,5]. This study is part of a follow-up of one of the oldest and largest asthma and allergy birth cohorts. Even if the prediction of asthma based on IgE levels at birth has not been of convincing value in later childhood or adulthood, it might still be a valuable indicator in certain high-risk cohorts
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