title: Effects of maternal geohelminth infections on allergy in early childhood.
abstract: BACKGROUND
  Maternal geohelminth infections during pregnancy may protect against allergy development in childhood.
  
  
  OBJECTIVE
  We sought to investigate the effect of maternal geohelminths on the development of eczema, wheeze, and atopy during the first 3 years of life.
  
  
  METHODS
  A cohort of 2404 neonates was followed to 3 years of age in a rural district in coastal Ecuador. Data on wheeze and eczema were collected by means of questionnaire and physical examination at 13, 24, and 36 months of age. Atopy was measured based on skin prick test (SPT) reactivity to 9 allergens at 36 months. Maternal stool samples were examined for geohelminths by microscopy. Data on potential confounders was collected after birth by questionnaire.
  
  
  RESULTS
  Geohelminths were observed in 45.9% of mothers. Eczema and wheeze were reported for 17.7% and 25.9%, respectively, of 2069 (86.1%) children with complete follow-up to 3 years, and allergen SPT reactivity to any allergen was present in 17.2% and to house dust mite in 8.7%. Maternal geohelminth infections were not significantly associated with eczema (adjusted odds ratio [OR], 1.26; 95% CI, 0.98-1.61), wheeze (adjusted OR, 1.02; 95% CI, 0.82-1.27), and SPT reactivity to any allergen (adjusted OR, 0.79; 95% CI, 0.61-1.01). In subgroup analyses maternal geohelminths were associated with a significantly reduced risk of SPT reactivity to mite and other perennial allergens, and maternal ascariasis was associated with an increased risk of eczema and reduced risk of SPT reactivity to all allergens.
  
  
  CONCLUSIONS
  Our data do not support a protective effect of maternal infections with geohelminth parasites during pregnancy against the development of eczema and wheeze in early childhood, although there was evidence in subgroup analyses for a reduction in SPT reactivity to house dust mites and perennial allergens.
authors.affiliation: Laboratorio de Investigaciones FEPIS, Avenida Via Guayllabamba, Quininde, Ecuador; Centro de Investigacion en Enfermedades Infecciosas, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador; Institute of Infection and Immunity, St George's University of London, London, United Kingdom. Electronic address: pcooper@sgul.ac.uk.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Cooper
authors.affiliation: Laboratorio de Investigaciones FEPIS, Avenida Via Guayllabamba, Quininde, Ecuador.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Chico
authors.affiliation: Instituto de Saude Coletiva, Universidade Federal da Bahia, Rua Basilio de Gama, Salvador, Brazil.
authors.forename: Leila D
authors.initials: LD
authors.lastname: Amorim
authors.affiliation: Laboratorio de Investigaciones FEPIS, Avenida Via Guayllabamba, Quininde, Ecuador.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sandoval
authors.affiliation: Laboratorio de Investigaciones FEPIS, Avenida Via Guayllabamba, Quininde, Ecuador.
authors.forename: Maritza
authors.initials: M
authors.lastname: Vaca
authors.affiliation: Instituto de Saude Coletiva, Universidade Federal da Bahia, Rua Basilio de Gama, Salvador, Brazil.
authors.forename: Agostino
authors.initials: A
authors.lastname: Strina
authors.affiliation: Instituto de Saude Coletiva, Universidade Federal da Bahia, Rua Basilio de Gama, Salvador, Brazil.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Campos
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rodrigues
authors.affiliation: Instituto de Saude Coletiva, Universidade Federal da Bahia, Rua Basilio de Gama, Salvador, Brazil.
authors.forename: Mauricio L
authors.initials: ML
authors.lastname: Barreto
authors.affiliation: Institute of Public Health Sciences, St George's University of London, London, United Kingdom.
authors.forename: David P
authors.initials: DP
authors.lastname: Strachan
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D002675:Child, Preschool; D004485:Eczema / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006373:Helminthiasis / Q000150:complications* / Q000469:parasitology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D063868:Patient Outcome Assessment; D011247:Pregnancy; D039981:Pyroglyphidae / Q000276:immunology; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors
chemical_list: D000485:Allergens
keywords: Geohelminths; atopy; early childhood; eczema; maternal infections; wheeze