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Published on: March 3, 2023
[Screening for the risk of allergy and prevention in French maternity units: A survey]
J-P Chouraqui1, U Simeoni2, C Tohier3
1Service de gastro-entérologie, hépatologie et nutrition pédiatriques, hôpital couple-enfant, CHU de Grenoble, avenue du Maquis-du-Grésivaudant, 38700 La Tronche, France.
Insights
Allergy prevention guidelines are known, but formal screening and prevention strategies for newborns are lacking in French maternity units. Hypoallergenic formulas are widely used for non-breastfed infants at risk of allergy.
Area of Science:
- Pediatric Allergy
- Public Health
- Neonatal Care
Context:
- Allergies affect nearly 30% of children, posing a significant public health challenge.
- Established guidelines for allergy prevention exist from the French Society of Paediatrics (SFP) and ESPACI.
- The AllerNaiss survey investigated current practices in French maternity units regarding allergy screening and prevention.
Purpose:
- To assess the implementation of allergy risk screening and prevention strategies in French maternity units.
- To evaluate awareness and adherence to existing pediatric allergy guidelines.
- To identify gaps in current practices for managing allergy risk in newborns.
Summary:
- While SFP guidelines are known by 82% and ESPACI by 55% of surveyed units, only 59% have a screening strategy, often based on local consensus.
- Screening primarily involves family history (99%), with varying implementation during pregnancy (51%), delivery (50%), and post-delivery (89%).
- Preventive measures exist in 62% of units, with hypoallergenic infant formula widely prescribed (90%) for non-breastfed infants.
Impact:
- Highlights a need for formalizing and standardizing allergy risk screening and prevention protocols in French maternity settings.
- Suggests opportunities for improved training and implementation of evidence-based allergy prevention strategies.
- Aims to reduce the burden of childhood allergies through enhanced neonatal care practices.
Abstract:
Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units.
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