A retrospective chart review to identify perinatal factors associated with food allergies.
BACKGROUND
Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies.


METHODS
Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis.


RESULTS
Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005).


CONCLUSIONS
Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.
Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA. kjd136@psu.edu
Kelly
K
Dowhower Karpa
Ian M
IM
Paul
J Alexander
JA
Leckie
Sharon
S
Shung
Nurgul
N
Carkaci-Salli
Kent E
KE
Vrana
David
D
Mauger
Tracy
T
Fausnight
Jennifer
J
Poger
D000900:Anti-Bacterial Agents / Q000009:adverse effects; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D056747:Immunomodulation; D015994:Incidence; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000276:immunology* / Q000382:microbiology; D008297:Male; D008423:Maternal Age; D008499:Medical Records; D010414:Pennsylvania / Q000453:epidemiology; D018743:Perinatal Care; D012189:Retrospective Studies; D012306:Risk; D012727:Sex Characteristics
D000900:Anti-Bacterial Agents