Exposure to high doses of birch pollen during pregnancy, and risk of sensitization and atopic disease in the child

被引:58
作者
Kihlström, A
Lilja, G
Pershagen, G
Hedlin, G
机构
[1] Huddinge Univ Hosp, Dept Paediat, Stockholm, Sweden
[2] Karolinska Inst, Sachs Childrens Hosp, Dept Paediat, Stockholm, Sweden
[3] Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden
[4] Karolinska Hosp, Dept Paediat, S-10401 Stockholm, Sweden
关键词
aeroallergens; antigen priming; atopy; intrauterine; sensitization;
D O I
10.1034/j.1398-9995.2003.00232.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: The role of maternal allergen exposure during pregnancy in sensitization and development of atopic disease in the child remains controversial. In the spring of 1993, extremely high levels of birch pollen were recorded in Stockholm, Sweden. In 1994, the corresponding pollen levels were low. The aim of this study was to assess the influence of exposure during pregnancy to high/low doses of birch pollen on the risk of sensitization and development of atopic disease in children. In addition, a comparison was made with children exposed to birch pollen in early infancy. Methods: Three hundred and eighty-seven children with atopic heredity, born in Stockholm in July-October 1993 or 1994 (mothers exposed during pregnancy), were investigated at age 4.5 years. The children were clinically examined and were skin prick tested (SPT) with inhalant and food allergens. IgE antibodies (RAST) against birch pollen and recombinant birch pollen allergen (rBet v 1) were analysed in serum. A comparison was made with a similar group of children exposed during the same incident, but in the first 3 months of life, in 1993. Results: The children of mothers high-dose exposed during pregnancy in 1993 tended to be more sensitized (SPTgreater than or equal to3 mm) to birch pollen than the children with low-dose exposure during the corresponding period in 1994 (7.6 and 4.6%, respectively, OR: 1.7; 95% CI: 0.7-4.1). A similar but weak tendency was seen for positive RAST analyses (greater than or equal to0.35 kU/l) against birch pollen and rBet v 1. Children of mothers high-dose exposed during pregnancy were significantly less sensitized to birch pollen than the children high-dose exposed in early infancy (17.9%, OR: 0.4; 95% CI: 0.2-0.7). There was an overall trend towards a slightly increased prevalence of bronchial asthma, allergic rhinoconjunctivitis and atopic dermatitis in the group with mothers high-dose exposed during pregnancy, compared to those with low exposure. Conclusion: Exposure of the mother during pregnancy to high levels of birch pollen resulted in a tendency towards increased risk of sensitization to the same allergen and symptoms of atopic disease in children with atopic heredity. Furthermore, our data indicate that exposure of the mother during pregnancy to inhalant allergens is less likely to result in sensitization in the child than exposure of the child in early infancy.
引用
收藏
页码:871 / 877
页数:7
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