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Pediatric peanut aspirations before and after 2015 recommendation for early peanut exposure
Lindsey Greenlund1, Amy Borden2, Amanda Nickel3
1University of Minnesota Medical School, USA.
Insights
The Learning Early About Peanut Allergy (LEAP) trial did not significantly change the rate of peanut foreign body aspirations (FBA) in children. Continued tracking of pediatric peanut aspirations is recommended.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Public Health
Background:
- The Learning Early About Peanut Allergy (LEAP) trial demonstrated early peanut consumption prevents allergies.
- This led to recommendations for early peanut exposure in at-risk children.
- Potential impact on foreign body aspiration (FBA) rates was unclear.
Purpose of the Study:
- To determine if peanut FBA rates in children increased post-LEAP trial publication.
- To analyze trends in pediatric peanut aspirations following guideline changes.
Main Methods:
- Retrospective chart reviews at two pediatric institutions.
- Inclusion criteria: children <7 years old undergoing bronchoscopy for FBA.
- Comparison of peanut FBA proportion before and after LEAP trial publication.
Main Results:
- No significant change in peanut FBA rates observed across both institutions combined (33.5% vs. 31.4%).
- Institution One: 53.5% vs. 45.1% (p=0.17).
- Institution Two: 41.4% vs. 28.6% (p=0.65).
Conclusions:
- Pediatric peanut FBA rates did not significantly change after the LEAP trial and AAP recommendations.
- Peanuts remain a significant cause of FBA, necessitating ongoing surveillance.
- Further multi-institutional, long-term data is needed to assess the impact of evolving recommendations and media influence.
Objectives:
To investigate if there has been an increase in peanut foreign body aspirations (FBA) in children since the publication of the Learning Early About Peanut Allergy (LEAP) trial, which revealed that early exposure to peanut-containing foods prevented peanut allergies in children at risk of atopic disease.
Methods:
Retrospective chart reviews were conducted separately at two pediatric institutions. Institutions One and Two reviewed children less than 7 years old who underwent bronchoscopy for FBA over ten-year periods between January 2007 and September 2017 and November 2008 and May 2018, respectively. The proportion of FBAs attributed to peanuts was compared before and after the publication LEAP.
Results:
Out of 515 reviewed cases, there was no change in pediatric peanut aspirations prior to and following the LEAP trial and AAP guideline change (33.5% vs 31.4%, p = 0.70). At Institution One, 317 patients met inclusion criteria. When comparing FBAs before and after LEAP, there were no significant changes in the rate of peanut aspiration (53.5% vs. 45.1%, p = 0.17). Institution Two also found no significant increase in the rate of peanut aspirations before and after the Addendum Guidelines (41.4% vs. 28.6%, p = 0.65) upon review of 198 cases.
Conclusions:
Multiple institutions demonstrated a non-significant change in the rate of peanut FBAs following the AAP recommendation. Given that peanuts comprise a large proportion of FBAs, it is important to continue to track peanut aspirations. Longer term data tracking is needed from more institutions to further understand how recommendations from other specialties and the media impacts pediatric aspiration outcomes.
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