Ege Markus Johannes, Herzum Ileana, Büchele Gisela, Krauss-Etschmann Susanne, Lauener Roger P, Roponen Marjut, Hyvärinen Anne, Vuitton Dominique A, Riedler Josef, Brunekreef Bert, Dalphin Jean-Charles, Braun-Fahrländer Charlotte, Pekkanen Juha, Renz Harald, von Mutius Erika
University Children's Hospital, Munich, Germany.
J Allergy Clin Immunol. 2008 Aug;122(2):407-12, 412.e1-4. doi: 10.1016/j.jaci.2008.06.011.
Previous cross-sectional surveys have suggested that maternal exposure to animal sheds during pregnancy exerted a protective effect on atopic sensitization in children lasting until school age.
We sought to evaluate the effects of maternal exposure to animal sheds and other farm-related exposures during pregnancy on cord blood IgE levels in a prospective birth cohort.
Pregnant women living in rural areas in Austria, Finland, France, Germany, and Switzerland were recruited in the third trimester of pregnancy. Information on maternal farm-related exposures, nutrition, and health during pregnancy was obtained by means of interviews. Specific IgE levels for food and common inhalant allergens were assessed in cord blood of 922 children and peripheral blood samples of their mothers.
Different sensitization patterns in cord blood of farm and nonfarm children were observed. In multivariable analysis consumption of boiled, but not unboiled, farm milk during pregnancy was positively associated with specific IgE to cow's milk independently from maternal IgE. In contrast, there was an inverse relationship between maternal exposure to animal sheds and cord blood IgE levels against seasonal allergens (adjusted odds ratio, 0.38; 95% CI, 0.21-0.70). This association was not confounded by maternal IgE levels. Maternal contact with hay enhanced the protective effect of exposure to animal sheds on IgE levels to grass pollen in cord blood.
Maternal exposure during pregnancy influences atopic sensitization patterns in cord blood. The (microbial) context of allergen contact possibly modifies the risk of atopic sensitization.
以往的横断面调查表明，孕期母亲接触畜棚对儿童特应性致敏具有保护作用，这种作用可持续至学龄期。
我们试图在前瞻性出生队列中评估孕期母亲接触畜棚及其他与农场相关的暴露因素对脐血IgE水平的影响。
招募了奥地利、芬兰、法国、德国和瑞士农村地区妊娠晚期的孕妇。通过访谈获取孕期母亲与农场相关的暴露、营养及健康方面的信息。对922名儿童的脐血及其母亲的外周血样本进行食物和常见吸入性过敏原特异性IgE水平评估。
观察到农场儿童和非农场儿童脐血中不同的致敏模式。多变量分析显示，孕期饮用煮沸而非未煮沸的农场牛奶与牛奶特异性IgE呈正相关，且独立于母亲的IgE水平。相比之下，母亲接触畜棚与脐血中针对季节性过敏原的IgE水平呈负相关（校正比值比为0.38；95%可信区间为0.21 - 0.70）。这种关联不受母亲IgE水平的影响。母亲接触干草增强了接触畜棚对脐血中草花粉IgE水平的保护作用。
孕期母亲接触会影响脐血中的特应性致敏模式。过敏原接触的（微生物）环境可能会改变特应性致敏的风险。
