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Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants.

2010 Dec

Journal Article

Sicherer, S.H.; Wood, R.A.; Stablein, D.; Lindblad, R.; Burks, W.; Liu, A.H.; Jones, S.M.; Fleischer, D.M.; Leung, D.Y.M.; Sampson, H.A.

J Allergy Clin Immunol






Arachis; Female; Humans; immunization; Immunoglobulin E; Infant; Infant, Newborn; Male; Maternal Exposure; Peanut Hypersensitivity; Pregnancy; Prevalence; Risk Factors; Skin Tests

BACKGROUND: Peanut allergy is typically severe, lifelong, and prevalent.OBJECTIVE: To identify factors associated with peanut sensitization.METHODS: We evaluated 503 infants 3 to 15 months of age (mean, 9.4 months) with likely milk or egg allergy but no previous diagnosis of peanut allergy. A total of 308 had experienced an immediate allergic reaction to cow's milk and/or egg, and 204 had moderate to severe atopic dermatitis and a positive allergy test to milk and/or egg. A peanut IgE level ≥5 kU(A)/L was considered likely indicative of peanut allergy.RESULTS: A total of 140 (27.8%) infants had peanut IgE levels ≥5 kU(A)/L. Multivariate analysis including clinical, laboratory, and demographic variables showed frequent peanut consumption during pregnancy (odds ratio, 2.9; 95% CI, 1.7-4.9; P < .001), IgE levels to milk (P = .001) and egg (P < .001), male sex (P = .02), and nonwhite race (P = .02) to be the primary factors associated with peanut IgE ≥5 kUA/L. Frequency of peanut consumption during pregnancy and breast-feeding showed a dose-response association with peanut IgE ≥5 kU(A)/L, but only consumption during pregnancy was a significant predictor. Among 71 infants never breast-fed, frequent consumption of peanut during pregnancy was strongly associated with peanut IgE ≥5 kU(A)/L (odds ratio, 4.99, 95% CI, 1.69-14.74; P < .004).CONCLUSION: In this cohort of infants with likely milk or egg allergy, maternal ingestion of peanut during pregnancy was strongly associated with a high level of peanut sensitization.

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