Gestational diabetes, atopic dermatitis, and allergen sensitization in early childhood.
BACKGROUND
The relationship between the prenatal environment, maternal-fetal interaction, and allergic disease in the offspring remains understudied.


OBJECTIVE
We sought to determine whether gestational diabetes (GDM) modifies the risk of early childhood atopic manifestations, including atopic dermatitis and allergen sensitization.


METHODS
This study includes 680 children from the Boston Birth Cohort. Mother-child dyads were recruited at birth and followed prospectively to a mean age of 3.2 +/- 2.3 years, with study visits aligned with the pediatric primary care schedule. The primary outcomes were physician-diagnosed atopic dermatitis on standardized medical record abstraction and allergen sensitization based on ImmunoCAP to 7 common foods and 5 common aeroallergens (specific IgE, >or=0.10 kUA/L; Phadia, Uppsala, Sweden). GDM was determined by means of standardized medical record review. Logistic regression analysis, stratified by term/preterm status, evaluated the association of GDM with atopic dermatitis and allergen sensitization, respectively, controlling for maternal prepregnancy body mass index, fetal growth, and pertinent covariates.


RESULTS
Of the 680 children, 488 were term, and 192 were preterm (<37 weeks' gestation). Overall, 4.9% of the mothers had GDM. Among the 680 children, 34.4% had atopic dermatitis, and 51% had allergen sensitization. In term births GDM was significantly associated with atopic dermatitis (odds ratio [OR], 7.2; 95% CI, 1.5-34.5) and allergen sensitization (OR, 5.7; 95% CI, 1.2-28.0). Adjusting for fetal growth had little effect. The association with sensitization was driven primarily by food sensitization (OR, 8.3; 95% CI, 1.6-43.3). The above associations were not observed in preterm births.


CONCLUSIONS
In term births GDM increased the risk of atopic dermatitis and early childhood allergen sensitization independently of maternal prepregnancy body mass index and fetal growth.
Kumar
Rajesh
R
Division of Allergy and Immunology, Children's Memorial Hospital, Chicago, Ill 60614, USA. rkumar@childrensmemorial.org
Ouyang
Fengxiu
F
Story
Rachel E
RE
Pongracic
Jacqueline A
JA
Hong
Xiumei
X
Wang
Guoying
G
Pearson
Colleen
C
Ortiz
Kathryn
K
Bauchner
Howard
H
Wang
Xiaobin
X
D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000276:immunology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D033261:Maternal-Fetal Relations; D011247:Pregnancy; D015995:Prevalence
D000485:Allergens