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Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring

Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of... ImportanceThe etiology of the increasing childhood prevalence of peanut or tree nut (P/TN) allergy is unknown. ObjectiveTo examine the association between peripregnancy consumption of P/TN by mothers and the risk of P/TN allergy in their offspring. Design, Setting, and ParticipantsProspective cohort study. The 10 907 participants in the Growing Up Today Study 2, born between January 1, 1990, and December 31, 1994, are the offspring of women who previously reported their diet during, or shortly before or after, their pregnancy with this child as part of the ongoing Nurses’ Health Study II. In 2006, the offspring reported physician-diagnosed food allergy. Mothers were asked to confirm the diagnosis and to provide available medical records and allergy test results. Two board-certified pediatricians, including a board-certified allergist/immunologist, independently reviewed each potential case and assigned a confirmation code (eg, likely food allergy) to each case. Unadjusted and multivariable logistic regression analyses were used to evaluate associations between peripregnancy consumption of P/TN by mothers and incident P/TN allergy in their offspring. ExposurePeripregnancy consumption of P/TN. Main Outcomes and MeasuresPhysician-diagnosed P/TN allergy in offspring. ResultsAmong 8205 children, we identified 308 cases of food allergy (any food), including 140 cases of P/TN allergy. The incidence of P/TN allergy in the offspring was significantly lower among children of the 8059 nonallergic mothers who consumed more P/TN in their peripregnancy diet (≥5 times vs <1 time per month: odds ratio = 0.31; 95% CI, 0.13-0.75; Ptrend = .004). By contrast, a nonsignificant positive association was observed between maternal peripregnancy P/TN consumption and risk of P/TN allergy in the offspring of 146 P/TN-allergic mothers (Ptrend = .12). The interaction between maternal peripregnancy P/TN consumption and maternal P/TN allergy status was statistically significant (Pinteraction = .004). Conclusions and RelevanceAmong mothers without P/TN allergy, higher peripregnancy consumption of P/TN was associated with lower risk of P/TN allergy in their offspring. Our study supports the hypothesis that early allergen exposure increases tolerance and lowers risk of childhood food allergy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Pediatrics American Medical Association

Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring

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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6203
eISSN
2168-6211
DOI
10.1001/jamapediatrics.2013.4139
pmid
24366539
Publisher site
See Article on Publisher Site

Abstract

ImportanceThe etiology of the increasing childhood prevalence of peanut or tree nut (P/TN) allergy is unknown. ObjectiveTo examine the association between peripregnancy consumption of P/TN by mothers and the risk of P/TN allergy in their offspring. Design, Setting, and ParticipantsProspective cohort study. The 10 907 participants in the Growing Up Today Study 2, born between January 1, 1990, and December 31, 1994, are the offspring of women who previously reported their diet during, or shortly before or after, their pregnancy with this child as part of the ongoing Nurses’ Health Study II. In 2006, the offspring reported physician-diagnosed food allergy. Mothers were asked to confirm the diagnosis and to provide available medical records and allergy test results. Two board-certified pediatricians, including a board-certified allergist/immunologist, independently reviewed each potential case and assigned a confirmation code (eg, likely food allergy) to each case. Unadjusted and multivariable logistic regression analyses were used to evaluate associations between peripregnancy consumption of P/TN by mothers and incident P/TN allergy in their offspring. ExposurePeripregnancy consumption of P/TN. Main Outcomes and MeasuresPhysician-diagnosed P/TN allergy in offspring. ResultsAmong 8205 children, we identified 308 cases of food allergy (any food), including 140 cases of P/TN allergy. The incidence of P/TN allergy in the offspring was significantly lower among children of the 8059 nonallergic mothers who consumed more P/TN in their peripregnancy diet (≥5 times vs <1 time per month: odds ratio = 0.31; 95% CI, 0.13-0.75; Ptrend = .004). By contrast, a nonsignificant positive association was observed between maternal peripregnancy P/TN consumption and risk of P/TN allergy in the offspring of 146 P/TN-allergic mothers (Ptrend = .12). The interaction between maternal peripregnancy P/TN consumption and maternal P/TN allergy status was statistically significant (Pinteraction = .004). Conclusions and RelevanceAmong mothers without P/TN allergy, higher peripregnancy consumption of P/TN was associated with lower risk of P/TN allergy in their offspring. Our study supports the hypothesis that early allergen exposure increases tolerance and lowers risk of childhood food allergy.

Journal

JAMA PediatricsAmerican Medical Association

Published: Feb 1, 2014

References