Maternal Consumption of Peanut During Pregnancy Is Associated with Peanut Sensitization in Atopic Infants
Year of Publication
Sicherer, S; Wood, R; Stablein, D; Lindblad, R; Burks, A; Liu, A; Jones, S; Fleischer, D; Leung, D; Sampson, H
J Allergy Clin Immunol
Arachis hypogaea/immunology; Female; Humans; immunization; Immunoglobulin E/blood; Infant; Male; Maternal Exposure/adverse effects*; Newborn; Peanut Hypersensitivity/blood; Peanut Hypersensitivity/diagnosis; Peanut Hypersensitivity/epidemiology
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.