Gestational and Early Life Risk Factors for Childhood Food Allergies

Abstract

Aim(s) The prevalence of food allergy among children has risen steadily over the past two decades, with 4 to 6% of children having at least one type of food allergy.[1,2] We investigated whether the occurrence of food allergies in childhood were related to factors known to influence the early microbiome and implicated in immune training (e.g., delivery mode, antibiotic use, proximity to a farm). We also assessed maternal consumption of foods during pregnancy for which children become allergic and maternal history of food allergies. Methods Participants, enrolled in the New Hampshire Birth Cohort Study, included 2,011 women with a singleton pregnancy and their offspring. We used Cox Proportional Hazards models to estimate the risk of a medical diagnosis of food allergies during the first five years of life in relation to maternal-infant characteristics, adjusted for potentially confounding factors. Results A greater risk of food allergies was associated with cesarean delivery (HR = 1.99; 95% CI: 1.06, 3.74) and prenatal antibiotic use (HR = 2.29; 95% CI: 1.15, 4.56). Daycare attendance (HR: 0.27; 95% CI: 0.15, 0.47) was inversely associated with risk. Children of mothers with a history of food allergies, consuming tree nuts or eggs during pregnancy and those living near a farm had a higher risk and those whose mothers ate peanuts prenatally had a lower risk, but these associations could have been due to chance. Conclusion(s) Prenatal factors related to the early acquisition of the microbiome, such as method of delivery, prenatal antibiotics, and day care correlated to risk of a food allergy diagnosis among children in the first 5 years of life. Developing a clearer understanding of allergy development and its risk factors is crucial to reducing the burden of food allergies. Key words Food allergy, daycare attendance, prenatal factors, early childhood, prenatal antibiotics