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Published on: August 7, 2017
Incidence and Early-Life Risk Factors for Food Allergy in a Spanish Birth Cohort
Jorge García-Ezquiaga1, Patricia Torija-Berzal1, Sergio Quevedo-Teruel1
1Pediatric Department, Severo Ochoa University Hospital, Leganés, Madrid, Spain.
Insights
Food allergy affects 7.2% of children by age 4. Key risk factors include atopic dermatitis for IgE-mediated allergies and early-life exposures for non-IgE-mediated forms.
Area of Science:
- Pediatrics
- Allergology
- Epidemiology
Background:
- Rising prevalence of food allergies in children.
- Need to understand early childhood incidence and risk factors.
Purpose of the Study:
- Determine cumulative incidence of food allergy in early childhood.
- Identify associated risk factors for food allergy.
Main Methods:
- Prospective birth cohort study of 1006 newborns in Spain.
- Follow-up to 4 years of age with data collection at birth and via interviews.
- Diagnostic methods included skin prick testing, IgE measurement, and oral food challenges.
Main Results:
- Cumulative incidence of food allergy was 7.2% by age 4.
- IgE-mediated food allergy linked to bronchospasm, atopic dermatitis, maternal asthma, and paternal allergic rhinitis.
- Non-IgE-mediated food allergy associated with proton-pump inhibitor use, no daycare, and early atopic dermatitis.
Conclusions:
- Food allergy impacts 7.2% of children by age 4 in this Spanish cohort.
- Atopic dermatitis is a primary risk factor for IgE-mediated food allergy.
- Modifiable early-life exposures correlate with non-IgE-mediated food allergy.
Aim:
The prevalence of food allergy has increased in recent decades. We aimed to determine the cumulative incidence of food allergy in early childhood and to identify associated risk factors.
Methods:
We conducted a prospective birth cohort study including 1006 newborns recruited over one year at a single hospital in Spain and followed until 4 years of age. Data were collected at birth and through structured telephone interviews during follow-up. Children with suspected food allergy underwent skin prick testing, specific serum IgE measurement and open oral food challenges when indicated.
Results:
The cumulative incidence of food allergy was 7.2% (72/1006). Independent risk factors for IgE-mediated food allergy included hospitalization for bronchospasm (adjusted odds ratio [aOR] 2.37; 95% CI 1.07-5.26), atopic dermatitis (aOR 7.52; 95% CI 3.77-15.01), maternal asthma (aOR 3.12; 95% CI 1.30-7.53) and paternal allergic rhinitis (aOR 2.79; 95% CI 1.31-5.94). Proton-pump inhibitor use, absence of daycare attendance and early-onset atopic dermatitis were associated with non-IgE-mediated food allergy.
Conclusion:
In this Spanish birth cohort, food allergy affected 7.2% of children by age 4. Atopic dermatitis was the main risk factor for IgE-mediated food allergy, while potentially modifiable early-life exposures were associated with non-IgE-mediated forms.
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