Maternal History Of Allergy Research Articles

Prenatal Maternal Risk Factors Contributing to Atopic Dermatitis: A Systematic Review and Meta-Analysis of Cohort Studies.

The gestational risk factors predispose to the manifestation of early childhood atopic dermatitis (AD). We evaluated the association between modifiable and non-modifiable gestational and prenatal risk factors that affect the AD prevalence in children. We performed the systematic review and meta-analysis of cohort studies (n=27) in PubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematic review according to Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarized cohort studies investigating gestational and prenatal risk factor those predispose to AD in off spring. Leading modifiable and non-modifiable were identified through ORs. Meta-analysis using the random effect model was also conducted to provide an overall estimate for several significant factors. Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval [CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history of eczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestation of AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16), exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking during pregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. Conclusively, both genetic and environmental factors play a pivotal role in early manifestation of AD. The better managing the environmental factors during gestational phase to the least can help curtail the prevalence of AD in children.

Relationship of Cord Blood Immunoglobulin E and Maternal Immunoglobulin E with Birth Order and Maternal History of Allergy in Albanian Mother/Neonate Pairs.

BACKGROUND:Previous studies reported that familial factors such as birth order and mothers atopy might influence cord blood levels and development of allergies.AIM:The aim of the study was to evaluate the relationship of cord blood IgE and maternal IgE with birth order and mothers history of allergy in Albanian mother/neonate pairs.MATERIAL AND METHODS:Study population represented 291 mother-infant pairs. Mothers were interviewed with a questionnaire for personal history of allergy and pregnancy history whereas serum IgE levels were determined using sandwich IRMA assay.RESULTS:The mean level of cIgE in neonates with detectable levels was 1.59 (n = 78). No significant difference in means of cIgE was found between first born and later born neonates (p = 0.232) and between neonates of mothers with a negative and positive history of allergy (p = 0.125). Also, no significant difference was found between means of mIgE by birth order, whereas there was a significant difference of mIgE between mothers with and without a history of allergy (p = 0.01). In a group of neonates with detectable cIgE levels, maternal IgE levels were moderately correlated with cIgE levels.CONCLUSION:Cord blood IgE is not affected by birth order and mothers history of allergy, whereas mothers IgE are affected by the history of allergy but not by birth order.

Duration and exclusiveness of breastfeeding and risk of childhood atopic diseases.

Breastfeeding may have immune modulatory effects that influence the development of childhood allergic sensitization and atopic diseases. We aimed to examine the associations of breastfeeding with childhood allergic sensitization, inhalant or food allergy and eczema, and whether any association was affected by disease-related modification of the exposure or modified by maternal history of allergy, eczema, or asthma. This study among 5828 children was performed in a population-based prospective cohort from fetal life onwards. We collected information on duration (<2months, 2-4months, 4-6months, and ≥6months) and exclusiveness (nonexclusive vs exclusive for 4months) of breastfeeding in infancy by postal questionnaires. At age 10years, inhalant allergic sensitization and food-allergic sensitization were measured by skin prick tests, and physician-diagnosed inhalant and food allergy by a postal questionnaire. Data on parental-reported eczema were available from birth until age 10years. We observed no association of breastfeeding with any allergic sensitization, physician-diagnosed allergy, or combination of these outcomes. Shorter breastfeeding duration was associated with an overall increased risk of eczema (P-value for trend <.05). Nonexclusively breastfed children had an overall increased risk of eczema (adjusted odds ratio [95% confidence interval]: 1.11 [1.01, 1.23]), compared with children exclusively breastfed for 4months. Risk period-specific sensitivity analyses, additional adjustment for ointment use for eczema at age 2months, and cross-lagged modeling showed no consistent results for disease-related modification of the exposure. Results were not modified by maternal history of allergy, eczema, or asthma (lowest P-value for interaction=.13). Shorter duration or nonexclusiveness of breastfeeding is associated with a weak overall increased risk of eczema but not allergic sensitization or physician-diagnosed allergy at age 10years.

Sociocultural characteristics, obesity and inflammatory biomarkers in Puerto Rican toddlers born in New York City

In the USA, Puerto Rican children have a higher prevalence of asthma than other Latino ethnicities, and acculturation is one of hypothesized reasons for this difference. We examined associations between sociocultural characteristics and serum leptin, high-sensitivity C-reactive protein (hsCRP), and body mass index (BMI), and further, among hsCRP, leptin levels, BMI percentiles, and allergic sensitization in 2-year-old children. IgE antibodies, leptin, and hsCRP concentrations were measured in serum from Puerto Rican toddlers (n = 143) born in New York City with a maternal history of allergy and/or asthma. Demographic and home characteristics questionnaires were administered to the mother, postpartum and two years later. Children's weight and height were measured to determine BMI percentiles. More girls (60%) had leptin levels above the median compared with boys (37%) (p = 0.0063). Leptin was positively correlated with BMI (r = 0.25; p = 0.0042). Children in daycare were more likely to be obese (40% vs. 24% p < 0.06). Maternal birthplace was significantly associated with children's leptin but not with hsCRP. Leptin levels were lower for children whose mothers were born on the US mainland (GM = 2.5 ng/ml, 95% CI [2.2-2.7]) compared with those whose mothers were born in Puerto Rico or another country (GM = 3.2 ng/ml, 95% CI [2.2-3.9], t-test p = 0.01). Mothers born in another country were more likely than those born in the US mainland or Puerto Rico to have obese children (60% vs. 26% p < 0.02). Leptin, hsCRP, and BMI percentile were not associated with sensitization to any of the measured inhalant allergens or total IgE. Even at a very young age, some acculturation factors were associated with biomarkers and anthropometric measures of obesity among this Puerto Rican pediatric population. To our knowledge, this is the first study demonstrating the association of mother's birth place with child BMI and leptin as early as 24 months.

Allergy Risk Is Mediated by Dendritic Cells with Congenital Epigenetic Changes

One factor predisposing toward allergic responses is a maternal history of allergy. In a mouse model of maternal transmission of asthma risk, offspring of asthmatic, but not normal, mothers show increased allergic susceptibility, recreating epidemiologic observations in humans. Dendritic cells (DCs) capture and process antigens, and can skew immune responses toward a pro-allergic T helper 2 phenotype. Genome-wide analysis shows that neonates of allergic mothers are born with substantial changes in DNA methylation in their splenic CD11c(+) DCs, findings observed without any contact with allergens. We demonstrate that these DCs from allergen-naive neonates born to asthmatic mothers, but not DCs from offspring of normal mothers, confer increased allergic susceptibility to multiple allergens when adoptively transferred into normal recipient mice, manifesting as increased airway responsiveness and allergic inflammation. Other immune splenocytes, including macrophages and CD4+ T cells, did not transfer the effect. The "asthma-susceptible" DCs also show enhanced allergen-presentation activity in vitro. Our findings suggest that maternal allergy results in an altered epigenetic profile in neonatal DCs that is independent of encounters with allergens and is linked to pro-allergic function.

Th1 and Th2 Chemokines, Vaccine-Induced Immunity, and Allergic Disease in Infants After Maternal ω-3 Fatty Acid Supplementation During Pregnancy and Lactation

We investigated whether the previously reported preventive effect of maternal ω-3 fatty acid supplementation on IgE-associated allergic disease in infancy may be mediated by facilitating a balanced circulating Th2/Th1 chemokine profile in the infant. Vaccine-induced immune responses at 2 y of age were also evaluated. Pregnant women, at risk of having an allergic infant, were randomized to daily supplementation with 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo from the 25th gestational week through 3.5 mo of breastfeeding. Infant plasma was analyzed for chemokines (cord blood, 3, 12, 24 mo) and anti-tetanus and anti-diphtheria IgG (24 mo). High Th2-associated CC-chemokine ligand 17 (CCL17) levels were associated with infant allergic disease (p < 0.05). In infants without, but not with, maternal history of allergy, the ω-3 supplementation was related to lower CCL17/CXC-chemokine ligand 11 (CXCL11) (Th2/Th1) ratios (p < 0.05). Furthermore, in nonallergic, but not in allergic infants, ω-3 supplementation was linked with higher Th1-associated CXCL11 levels (p < 0.05), as well as increased IgG titers to diphtheria (p = 0.01) and tetanus (p = 0.05) toxins. Thus, the prospect of balancing the infant immune system toward a less Th2-dominated response, by maternal ω-3 fatty acid supplementation, seems to be influenced by allergic status.

First evidence of a possible association between gastric acid suppression during pregnancy and childhood asthma: a population‐based register study

Recent data in mice suggest that acid suppression during pregnancy yields offspring with type 2 T helper-dominant immunity, suggesting a predisposition for allergy. To determine the association of in utero exposure to acid-suppressive medications and the subsequent development of allergic diseases in children. We studied a population-based observational cohort formed by linking data from three Swedish national healthcare registers: the Medical Birth Register, the Hospital Discharge Register, and the Swedish Prescribed Drug Register. Main outcome measures included a hospital discharge diagnosis of an allergic disease or prescription for asthma medications, epinephrine auto-injectors, antihistamines or steroid ointments in children. Data were analysed using the Mantel-Haenszel procedure. Twenty-nine thousand four hundred and ninety (5.03%) children had a discharge diagnosis of allergy or prescriptions for allergy medications. Five thousand six hundred and forty-five (0.96%) children had been exposed to acid suppression therapy during pregnancy; of these, 405 (0.07%) were treated for allergic diseases. Exposure to acid-suppressive medications in utero was associated with an increased odds ratio (OR) for developing allergy (OR 1.43, 95% confidence interval (95% CI) 1.29-1.59). We observed this association irrespective of the type of drug, time of exposure during pregnancy, and maternal history of allergy. The use of maternal acid-suppressive medication was associated with an increased OR for the development of childhood asthma (3.7% in the population at large vs. 5.6% in exposed children, OR 1.51, 95% CI 1.35-1.69), but not for other allergic diseases. These data provide first evidence of a significant association between in utero exposure to acid-suppressive drugs and the risk of developing childhood asthma.

Acid Blocking Therapy During Pregnancy Increases the Odds for Childhood Asthma

RationaleSince recent data suggest that acid blockade therapy in pregnant mice primes the fetal immune system towards allergy, we examined the effect of human prenatal exposure to acid blocking medications on the development of allergies in children.MethodsRetrospective observational cohort study using three Swedish national health care registers: the Medical Birth Register (1995-2004), the Hospital Discharge Register (1995-2006), and the Swedish Prescribed Drug Register (2005-2006). Main outcome measures included hospital discharge diagnosis of allergic disease (asthma, food allergy, atopic dermatitis, unspecified allergic reaction/anaphylaxis, allergic rhinitis) or prescription for allergy medication (asthma medications, epinephrine auto-injector, antihistamines, steroid ointments) in children exposed to acid blockade therapy in utero and in non-exposed children.ResultsMaternal intake of acid blocking medications during pregnancy increased their children's odds for asthma significantly by 51% (OR 1.51, 95% CI 1.35-1.69), but did not increase the odds for other allergic diseases (OR 1.13, 95% CI 0.91-1.40). This effect was preserved irrespective of the type of acid blocking drug, time of exposure during pregnancy, and maternal history of allergy.ConclusionPrenatal exposure to acid blocking drugs increases the odds of developing childhood asthma. This data provides first evidence for a novel potential risk factor for the development of allergic diseases in children. RationaleSince recent data suggest that acid blockade therapy in pregnant mice primes the fetal immune system towards allergy, we examined the effect of human prenatal exposure to acid blocking medications on the development of allergies in children. Since recent data suggest that acid blockade therapy in pregnant mice primes the fetal immune system towards allergy, we examined the effect of human prenatal exposure to acid blocking medications on the development of allergies in children. MethodsRetrospective observational cohort study using three Swedish national health care registers: the Medical Birth Register (1995-2004), the Hospital Discharge Register (1995-2006), and the Swedish Prescribed Drug Register (2005-2006). Main outcome measures included hospital discharge diagnosis of allergic disease (asthma, food allergy, atopic dermatitis, unspecified allergic reaction/anaphylaxis, allergic rhinitis) or prescription for allergy medication (asthma medications, epinephrine auto-injector, antihistamines, steroid ointments) in children exposed to acid blockade therapy in utero and in non-exposed children. Retrospective observational cohort study using three Swedish national health care registers: the Medical Birth Register (1995-2004), the Hospital Discharge Register (1995-2006), and the Swedish Prescribed Drug Register (2005-2006). Main outcome measures included hospital discharge diagnosis of allergic disease (asthma, food allergy, atopic dermatitis, unspecified allergic reaction/anaphylaxis, allergic rhinitis) or prescription for allergy medication (asthma medications, epinephrine auto-injector, antihistamines, steroid ointments) in children exposed to acid blockade therapy in utero and in non-exposed children. ResultsMaternal intake of acid blocking medications during pregnancy increased their children's odds for asthma significantly by 51% (OR 1.51, 95% CI 1.35-1.69), but did not increase the odds for other allergic diseases (OR 1.13, 95% CI 0.91-1.40). This effect was preserved irrespective of the type of acid blocking drug, time of exposure during pregnancy, and maternal history of allergy. Maternal intake of acid blocking medications during pregnancy increased their children's odds for asthma significantly by 51% (OR 1.51, 95% CI 1.35-1.69), but did not increase the odds for other allergic diseases (OR 1.13, 95% CI 0.91-1.40). This effect was preserved irrespective of the type of acid blocking drug, time of exposure during pregnancy, and maternal history of allergy. ConclusionPrenatal exposure to acid blocking drugs increases the odds of developing childhood asthma. This data provides first evidence for a novel potential risk factor for the development of allergic diseases in children. Prenatal exposure to acid blocking drugs increases the odds of developing childhood asthma. This data provides first evidence for a novel potential risk factor for the development of allergic diseases in children.

Risk factors and characteristics associated with severe and difficult to treat asthma phenotype: an analysis of the ENFUMOSA group of patients based on the ECRHS questionnaire

Severe and difficult to treat asthma impairs health status and accounts for about half of asthma expenditure. In 1994, a European Network For Understanding Mechanisms of Severe Asthma (ENFUMOSA) was formed. A large group of patients from nine European countries has been selected. To examine the risk factors and symptoms associated with a phenotype of severe/difficult to treat asthma. The present report presents data assessed through the use of the European Community Respiratory Health Survey (ECRHS) Questionnaire in 148 mild-moderate controlled and 155 severe asthmatics from the ENFUMOSA group. There is a negative association of severe asthma with reported allergy and with a family history of allergy (Odds ratio (OR)=0.45). Sharing a bedroom before the age of five is associated with a higher risk of severe asthma (OR=1.5) while childhood infections, play school attendance and exposure to allergens or animals are not. A larger proportion of severe asthma patients report symptoms at work (OR=2.7) or have to change jobs (OR=4.3) and fewer severe than mild patients are currently employed (OR=0.39). Smoking and exposure to smoke is similar in mild and severe asthma. Dietary habits do not differ between the groups, but severe asthmatics report eating less savoury snacks and there is a trend for lower intake of sweets. Analysis of the ECRHS questionnaire in the ENFUMOSA study shows that severe asthma patients experience more symptoms and their health status is impaired by their inability to work and perhaps eat freely. Personal and maternal history of allergy is associated with mild but not severe asthma. Other than sharing a bedroom before the age of 5 years, no childhood exposure risk factors associated with severe asthma could be identified from this analysis.

Relationship between distance from major roads and adolescent health in Japan.

A relationship between distance from major roads and the prevalence of allergic disorders and general symptoms among junior high school students was assessed, separating the effects of distance of residence and school from the roads. Study subjects were 5,652 students aged 12 to 15 years. This study used diagnostic criteria from the International Study of Asthma and Allergies in Childhood. The questionnaire also asked about symptoms of headache, stomachache, tiredness, and cough and the shortest distance from residence to major roads. Distance from school to the nearest major road was measured on a map. Adjustment was made for gender, grade, the number of older siblings, smoking in the household, and maternal history of allergy. A shorter distance between residence and major roads was associated with an increased prevalence of headache, stomachache, tiredness, and cough. There was a marginally significant positive association between residence facing major roads and the prevalence of allergic rhinoconjunctivitis. Residence within 100 m of major roads showed a tendency for a positive relationship with the prevalence of wheeze and atopic dermatitis. There was no apparent relationship between distance of school from major roads and allergic disorders or the general symptoms. The findings suggest that proximity of residence, not school, to major roads may be associated with an increased prevalence of allergic disorders, headache, stomachache, and tiredness among Japanese adolescents. Further investigations with more precise and detailed exposure and health outcome measurements are needed to corroborate the relationship between traffic related factors and allergic disorders and general symptoms.