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Influence of sex and gestational age on cord blood IgE
J Kimpen1, H Callaert, P Embrechts
1Department of Microbiology, Dr L. Willems-Instituut, Diepenbeek, Belgium.
Insights
Cord blood IgE (immunoglobulin E) levels are higher in boys than girls, impacting atopy screening accuracy. Gestational age does not affect these levels in newborns after 34 weeks.
Area of Science:
- Neonatal immunology
- Allergy and immunology
- Pediatric screening
Background:
- Cord blood immunoglobulin E (CB-IgE) is a key screening marker for atopy.
- Accurate reference values for CB-IgE are essential for effective screening programs.
- Previous studies have not fully elucidated the influence of sex and gestational age on CB-IgE levels.
Purpose of the Study:
- To investigate the impact of sex and gestational age on cord blood IgE levels.
- To determine if sex-specific cut-off values are necessary for CB-IgE screening.
- To establish accurate normal ranges for CB-IgE in newborns.
Main Methods:
- Analysis of 5,305 cord blood samples.
- Statistical evaluation of CB-IgE concentrations in relation to newborn sex.
- Assessment of CB-IgE levels across different gestational ages (34-42 weeks).
Main Results:
- Boys exhibited significantly higher CB-IgE levels compared to girls (p < 0.001).
- The proportion of 'abnormal' CB-IgE values was significantly higher in boys, especially with lower cut-off thresholds.
- Gestational age (34-42 weeks) did not influence absolute CB-IgE concentration or the number of abnormal values.
Conclusions:
- Sex is a significant factor influencing CB-IgE levels and should be considered in atopy prediction and prevention programs.
- Adjusting for sex is particularly important when utilizing lower CB-IgE cut-off values.
- Gestational age has no discernible impact on CB-IgE levels for infants born after 34 weeks gestation.
Abstract:
Cord blood IgE (CB-IgE) is widely used as a screening parameter for atopy. Therefore it is necessary to define the normal values accurately. In this study influence of sex and gestational age on CB-IgE is evaluated. 5,305 cord blood samples were analysed. Boys had a higher CB-IgE than girls (p less than 0.001). Using a cut-off value for normal of 2.4 micrograms/l, boys had significantly more abnormal values than girls (p = 0.0475). Using a lower cut-off value (2.16, 1.92, 1.68 micrograms/l) the difference became more significant (p = 0.0029, p = 0.0036 and p = 0.0019 respectively). Gestational age (in the range from 34-42 weeks of gestation) had no influence on the absolute CB-IgE concentration nor on the number of abnormal values. From this study we may conclude that, when CB-IgE is used in prediction and prevention programs for atopic disease, the sex of the newborn should be taken into consideration when evaluating the results, in particular when the cut-off limit is lowered. No correction needs to be made for gestational age if the baby is born after the 34th week of gestation.