Abstract

BackgroundAlthough an inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified. There is no epidemiological research regarding the sibling effect on allergic disorders in Japanese adults. The current cross-sectional study examined the relationship between number of siblings and prevalence of allergic disorders among adult women in Japan.MethodsSubjects were 1745 pregnant women. This study was based on questionnaire data. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, region of residence, pack-years of smoking, secondhand smoke exposure at home and at work, family history of asthma, atopic eczema, and allergic rhinitis, household income, and education.ResultsThe prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 10.4%, 5.5%, 13.0%, and 25.9%, respectively. A significant inverse exposure-response relationship was observed between the number of older siblings and rhinoconjunctivitis, but not wheeze, asthma, or eczema (P for trend = 0.03); however, the adjusted odds ratio (OR) for having 2 or more older siblings was not significant although the adjusted OR for having 1 older sibling was statistically significant (adjusted OR = 0.71 [95% CI: 0.56-0.91]). Number of total siblings and number of younger siblings were not related to wheeze, asthma, eczema, or rhinoconjunctivitis.ConclusionsThis study found a significant inverse relationship between the number of older siblings and the prevalence of rhinoconjunctivitis among pregnant Japanese women. Our findings are likely to support the intrauterine programming hypothesis; however, we could not rule out the hygiene hypothesis.

Highlights

  • An inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified

  • A cohort study in the USA found no association between birth order and total cord blood IgE level [8], another recent study reported a significant interaction between birth order and IL13 polymorphisms affecting allergic sensitization: the effect of IL13 was restricted only to firstborn children, suggesting adverse prenatal programming in firstborn offspring [9]

  • A significant inverse exposure-response relationship was observed between number of older siblings and the prevalence of rhinoconjunctivitis (P for trend = 0.03); the adjusted odds ratio (OR) for having 2 or more older siblings was not statistically significant, the adjusted OR for having 1 older sibling was statistically significant

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Summary

Introduction

An inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified. The current cross-sectional study examined the relationship between number of siblings and prevalence of allergic disorders among adult women in Japan. The intrauterine programming hypothesis has been proposed as an alternative explanation of the mechanism of the sibling effect [1]. According to this theory, maternal immunomodulation acquired through multiple pregnancies might be transmitted to the developing fetus [5,6,7]. The current cross-sectional study examined the relationship between number of siblings and the prevalence of allergic disorders in Japanese pregnant women using baseline data from the Kyushu Okinawa Maternal and Child Health Study (KOMCHS)

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