title: A prospective birth cohort study of different risk factors for development of allergic diseases in offspring of non-atopic parents.
abstract: BACKGROUND
  Allergic diseases are thought to be inherited. Prevalence of allergic diseases has, however, increased dramatically in last decades, suggesting environmental causes for the development of allergic diseases.
  
  
  OBJECTIVE
  We studied risk factors associated with the development of atopic dermatitis (AD), allergic rhinitis (AR) and asthma (AS) in children of non-atopic parents in a subtropical country.
  
  
  METHODS
  In a birth cohort of 1,497 newborns, parents were prenatally enrolled and validated for allergic diseases by questionnaire, physician-verified and total or specific Immunoglobulin E (IgE) levels; 1,236 and 756 children, respectively, completed their 3-year and 6-year follow-up. Clinical examination, questionnaire, and blood samples for total and specific IgE of the children were collected at each follow-up visit.
  
  
  RESULTS
  Prevalence of AD, AR and AS was, respectively, 8.2%, 30.8% and 12.4% in children of non-atopic parents. Prevalence of AR (p<.001) and AS (p=.018) was significantly higher in children of parents who were both atopic. A combination of Cesarean section (C/S) and breastfeeding for more than 1 month showed the highest risk for AD (OR=3.111, p=.006). Infants living in homes with curtains and no air filters had the highest risk for AR (OR=2.647, p<.001), and male infants of non-atopic parents living in homes without air filters had the highest risk for AS (OR=1.930, p=.039).
  
  
  CONCLUSIONS
  Breastfeeding and C/S affect development of AD. Gender, use of curtains and/or air filters affect AR and AS, suggesting that control of the perinatal environment is necessary for the prevention of atopic diseases in children of non-atopic parents.
authors.affiliation: Research Assistant Center, Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Ming-Tsung
authors.initials: MT
authors.lastname: Lee
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taiwan.|Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Ou
authors.affiliation: Departments of Pediatrics and Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Jen-Chieh
authors.initials: JC
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.
authors.forename: Chieh-An
authors.initials: CA
authors.lastname: Liu
authors.affiliation: Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Lu
authors.initials: CL
authors.lastname: Wang
authors.affiliation: Departments of Pediatrics and Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hau
authors.initials: H
authors.lastname: Chuang
authors.affiliation: Departments of Pediatrics and Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ho-Chang
authors.initials: HC
authors.lastname: Kuo
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Te-Yao
authors.initials: TY
authors.lastname: Hsu
authors.affiliation: Department of Medical Research, MacKay Memorial Hospital, Taipei.
authors.forename: Chie-Pein
authors.initials: CP
authors.lastname: Chen
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taiwan.|Department of Medical Research, MacKay Memorial Hospital, Taipei.|Department of Pediatrics, MacKay Memorial Hospital, Taipei.|Institute of Biomedical Sciences, MacKay Medical College, New Taipei, Taiwan.
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
mesh_terms: D001249:Asthma / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D015995:Prevalence; D011446:Prospective Studies; D065631:Rhinitis, Allergic / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
chemical_list: D007073:Immunoglobulin E
keywords: allergic rhinitis; asthma; atopic dermatitis; birth cohort; perinatal environment