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Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study)

Authors

  • M. M. Hagendorens,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • C. H. Bridts,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • K. Lauwers,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • S. Van Nuijs,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • D. G. Ebo,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • A. Vellinga,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • L. S. De Clerck,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • H. P. Van Bever,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • J. J. Weyler,

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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  • W. J. Stevens

    1. Departments of *Paediatrics, †Immunology – Allergology – Rheumatology and, ‡Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium§Department of Paediatrics, National University Singapore, Singapore
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Professor W. J. Stevens, Department of Immunology, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium.
E-mail: Immuno@ua.ac.be

Summary

Objective To evaluate the influence of perinatal environmental factors on early sensitization, atopic dermatitis and wheezing during the first year.

Methods Information on pregnancy-related factors, parental atopic history, environmental factors and the clinical course of the infant until age one was gathered by questionnaires, as part of a prospective birth cohort study (Prospective study on the Influence of Perinatal factors on the Occurrence of asthma and allergies [PIPO-study]). Quantification of total and specific IgE was performed in 810 children and their parents.

Results Early sensitization was found in 107/810 (13%) of the infants. Multiple regression analysis showed that specific IgE in fathers was a risk factor for early sensitization in their daughters (adjusted odds ratios (ORadj) 2.21 (95% confidence interval (CI) 1.10–4.49); P=0.03), whereas in boys, day care attendance was shown to be protective for early sensitization (ORadj 0.38 (95% CI 0.20–0.71); P=0.001). Atopic dermatitis occurred in 195/792 infants (25%). Specific IgE in the mother (ORadj 1.52 (95% CI 1.06–2.19); P=0.02) and in the infant (ORadj 4.20 (95% CI 2.63–6.68); P<0.001) were both risk factors for the occurence of atopic dermatitis, whereas postnatal exposure to cats was negatively associated with atopic dermatitis (ORadj 0.68 (0.47–0.97); P=0.03).

Postnatal exposure to cigarette smoke (ORadj 3.31 (95% CI 1.79–6.09); P<0.001) and day care attendance (ORadj 1.96 (95% CI 1.18–3.23); P=0.009) were significantly associated with early wheezing, which occurred in 25% (197/795) of the infants.

Conclusion The effect of paternal sensitization and day care attendance on sensitization is gender dependent. Maternal sensitization predisposes for atopic dermatitis, whereas postnatal exposure to cats had a protective effect.

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