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Published on: August 7, 2017
Breastfeeding and perinatal exposure, and the risk of asthma and allergies
Caroline J Lodge1, Shyamali C Dharmage
1aAllergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne bMurdoch Children's Research Centre, Royal Childrens Hospital, Melbourne, Victoria, Australia.
Insights
Perinatal exposures significantly impact infant immune development and allergy risk. Maternal health, environmental factors, and early life exposures influence offspring asthma and eczema development.
Area of Science:
- Immunology
- Environmental Health
- Pediatrics
Background:
- Perinatal period is critical for immune system development.
- Exposures during this phase can have lasting effects on disease risk.
- Infant immune maturation is closely linked to allergy and asthma development.
Purpose of the Study:
- To review current literature on perinatal exposures.
- To examine the relationship between perinatal exposures and allergic disease risk.
- To summarize evidence on asthma and allergic disease risk factors in offspring.
Main Methods:
- Literature review and synthesis of existing studies.
- Analysis of associations between various perinatal exposures and offspring health outcomes.
- Identification of risk and protective factors for allergic diseases.
Main Results:
- Maternal obesity, infections, and certain environmental chemicals (BPA, phthalates) increase asthma risk.
- Smoking in utero, low birth weight, and C-section are linked to higher asthma risk.
- Vitamin E, zinc, and selenium intake may reduce asthma risk; hookworm infection reduces eczema risk.
Conclusions:
- Diverse perinatal exposures influence allergic disease risk, underscoring infant susceptibility.
- Public health messaging on maternal health (obesity, smoking) and breastfeeding is crucial.
- The infant gut microbiome is a potential mediator for perinatal exposure effects on allergic disease.
Purpose Of Review:
Exposures during the perinatal period, a phase of rapid development, may have a profound and sustained effect on disease risk. In particular, perinatal exposures may influence the development and maturation of the infant immune system and the risk of allergic disease. We aimed to summarize the current literature on perinatal exposures and the risk of asthma and allergic disease
Recent Findings:
Increased risk of offspring wheeze or asthma was found for: maternal obesity and hypertension during pregnancy; febrile illness, gynaecological, and viral respiratory infections in pregnancy; exposure to bisphenol A and phthalates in pregnancy and childhood; exposure to smoking in utero; low birth weight; caesarean section and neonatal hyperbilirubinaemia. Reduced risk of offspring atopic eczema was found for hookworm infection in pregnancy and reduced risk of offspring wheeze was associated with increased pregnancy dietary intake of vitamin E and zinc. Higher levels of selenium in pregnancy were associated with less risk of asthma in genetically susceptible offspring. Early life pet ownership was associated with a decrease in atopic asthma but an increase in nonatopic asthma risk.
Summary:
A diverse range of exposures were associated with allergic disease risk, highlighting the susceptibility of children during the perinatal period. Clinicians should reinforce public health messages concerning maternal obesity, smoking, and breastfeeding. The infant gut microbiome is emerging as an important hypothesis, which may mediate the relationship between many perinatal exposures and allergic disease.
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