Maternal fatty acid status in pregnancy and childhood atopic manifestations: KOALA Birth Cohort Study.
BACKGROUND
Prevalence of atopic disorders has increased rapidly, but aetiological factors responsible for this increase are still largely unknown. Prenatal exposure to a pro-inflammatory fatty acid status is hypothesized although little research has been carried out.


OBJECTIVE
To investigate whether prenatal fatty acid exposures are associated with atopy in childhood.


METHODS
In the KOALA Birth Cohort Study, maternal blood samples (n=1275) at 34-36 weeks of pregnancy were assayed for n-6 and n-3 long-chain polyunsaturated fatty acids (LCPs). The full spectrum of offspring atopic manifestations (wheeze, asthma, allergic rhinoconjunctivitis, eczema, atopic dermatitis, allergic sensitization, and high total IgE) until the age of 6-7 years was assessed by repeated parental questionnaires and measurements of total and specific IgE. Associations of maternal fatty acid status with child atopic outcomes were analysed using multivariable logistic regression and generalized estimating equations for repeated measurements.


RESULTS
High ratio of maternal n-6 vs. n-3 LCPs was associated with a lower risk of eczema in the child (P for trend 0.012). More specifically, we found a decreased risk of eczema in the first 7 months of life with increasing arachidonic acid levels (P for trend 0.013). No associations were found between maternal fatty acids and offspring airway-related atopic manifestations, sensitization, or high total IgE.


CONCLUSIONS
The development of atopic disorders in early childhood is associated with prenatal exposure to n-6 vs. n-3 fatty acids, but with inconsistencies between different manifestations. Further exploration of associations with maternal diet and genetic variants in genes regulating fatty acid metabolism are required. This study shows that the influence of prenatal exposure to fatty acids on the risk of eczema in the child is limited to the first year of life.
Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
M L
ML
Notenboom
M
M
Mommers
E H J M
EH
Jansen
J
J
Penders
C
C
Thijs
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects*; D015525:Fatty Acids, Omega-3 / Q000097:blood* / Q000276:immunology; D043371:Fatty Acids, Omega-6 / Q000097:blood* / Q000276:immunology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D015995:Prevalence; D011795:Surveys and Questionnaires
D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6