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- Title
Genetic and environmental factors affecting the development of atopy through age 4 in children of atopic parents: a prospective randomized study of food allergen avoidance.
- Authors
Zeiger, R. S.; Heller, S.; Mellon, M. H.; Halsey, J. F.; Hamburger, R. N.; Sampson, H. A.
- Abstract
The effect of food allergen avoidance, as well as other environmental and genetic factors, on the development of atopy were determined in this follow-up report of a prospective randomized controlled study of 288 infants of atopic parents, in which 78% were available for evaluation at age 4 years. The prophylactic-treated group consisted of mothers who avoided cow milk, egg, and peanut during the last trimester of pregnancy and lactation and of infants who avoided cow milk until 1 year (casein hydrolysate supplementation prior to 1 year) and egg, peanut, and fish until after 2 years. The control group consisted of maternal/ infant pairs who followed standard feeding practices. The cumulative prevalence of food allergy and food sensitization remained lower in the prophylactic-treated group from 1 to 4 years of age. However, the period (current) prevalence of food allergy in both study groups was similar (about 5%) at 3 and 4 years. Such findings suggest that period prevalence may represent the more appropriate measure to assess the impact of intervention measures on the development of atopic disease at older ages. Prophylactic-treated children evidenced lower levels of IgG beta-lactoglobulin (BLG) at 4 months and 1 and 2 years (p < 0.0001 ) and lower IgG ovalbumen/ovomueoid (OVA) levels only at 2 years (p < 0.001). Both groups evidenced similar prevalences of asthma, allergic rhinitis, and positive inhalant skin tests from birth to 4 years. Children with food allergy evidenced higher 4 year cumulative prevalences of allergic rhinitis and asthma (p <0.05). Risk factors for atopic disease by age 4 years were shown by muitivariate analysis (p < 0.05) to include (1) unrestricted diet and elevated cord blood IgE with food allergy. (2) male gender and lower paternal level of education with asthma, and (3) non-caucasian ethnicity and spring/summer birth with atopic dermatitis and allergic rhinitis. Serum igE levels were not significantly different between...
- Subjects
ALLERGENS; FOOD allergy; IMMUNOGLOBULIN G; IMMUNOGLOBULIN E; ALLERGIC rhinitis; ASTHMA; SERUM
- Publication
Pediatric Allergy & Immunology, 1992, Vol 3, Issue 3, p110
- ISSN
0905-6157
- Publication type
Article
- DOI
10.1111/j.1399-3038.1992.tb00035.x