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Relationships among prenatal aeroallergen exposure and maternal and cord blood IgE: Project ACCESS

https://doi.org/10.1016/j.jaci.2009.02.027Get rights and content

Background

Whereas some evidence suggests that antigen sensitization may begin prenatally, the influence of maternal allergen exposure during pregnancy has not been fully elucidated.

Objectives

We examined the relationship between prenatal maternal aeroallergen exposure and cord blood total IgE and the potential mediating/indirect effect of maternal immune response.

Methods

This study was performed in 301 mother-infant pairs enrolled in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project, a study examining the effects of prenatal and early life social and physical environmental exposures on urban asthma risk. Dust samples collected prenatally from mothers' bedrooms were analyzed for cockroach and dust mite allergens. Cord blood was analyzed for total IgE, and maternal serum collected during pregnancy for total and specific IgE. We assessed the relationship between prenatal exposure and cord blood total IgE and the potential mediation effect adjusting for maternal age, race, education, smoking status, and dust collection season; and child's sex and season of birth.

Results

In multivariate models, elevated prenatal dust mite levels (>0.2 μg/g) increased cord blood IgE concentrations by 29% (P = .08), and continuous dust mite concentration was associated with a significant nonlinear increase in cord blood IgE (P = .02). Elevated prenatal exposure to cockroach allergen (>2 U/g) was not associated with cord blood IgE, but showed a significant indirect relationship through maternal total IgE (β = 0.23; 95% CI, 0.08–0.41).

Conclusion

These results demonstrate that maternal prenatal exposure to household allergens may affect cord blood IgE, albeit the underlying mechanism may be allergen-specific.

Section snippets

Study participants

Cross-sectional analyses were conducted in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project, an ongoing prospective cohort of mother-child pairs originally funded to recruit 500 pregnant women and their children to study the main effects of prenatal maternal and early life stress and other environmental risk factors on urban childhood asthma risk (described in detail elsewhere21). Briefly, English-speaking or Spanish-speaking pregnant women who were at least 18

Sample characteristics

Characteristics of the study participants are shown in Table I. The mean maternal age was 26.6 years. The population was predominately Hispanic (61.8%), and 36% of the mothers had a history of allergic disease with symptoms.

The percent of homes with dust mite allergen concentrations >0.20 μg/g was 67.6%, and with concentrations >2 μg/g, 38.1%. The percent of homes with cockroach allergen concentrations >2 U/g was 18.5%, and with concentrations >8 U/g, 8.33%.

Cord blood IgE was detected in 82.4%

Discussion

In this study, we examined the impact of prenatal maternal exposure to dust mite and cockroach allergens on cord blood IgE and the relationships among allergen exposure, maternal immune response, and cord blood IgE. We found that elevated dust mite in household dust measured during pregnancy significantly affected cord blood IgE levels. Conversely, we observed no association of cockroach allergen with cord blood IgE concentrations, but instead found a significant indirect relationship operating

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    Supported by the National Institutes of Health R01ES010932, U01HL072494, R01HL080674, A1-20565, R01A135786, T32MH073122.

    Disclosure of potential conflict of interest: J. L. Peters has received research support from the National Institutes of Health and the Robert Wood Johnson Foundation. T. A. E. Platts-Mills serves on the scientific advisory board for Indoor Biotechnologies and has received research support from Indoor Biotechnologies, ImClone, and Phadia. D. R. Gold has received research support from the National Institutes of Health and the Environmental Protection Agency, and is a delegate to American Lung Association for the American Thoracic Society. R. J. Wright has received research support from the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.

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