Department of Health Sciences, School of Medicine, University of Yamanashi, Yamanashi, Japan.
Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan.
Pediatr Int. 2021 Sep;63(9):1026-1032. doi: 10.1111/ped.14635. Epub 2021 Jul 14.
The aim of this study was to explore the association between maternal allergies and preterm birth by different total immunoglobulin E (IgE) levels.
Data of 81 791 pregnant women from the Japan Environment and Children's Study, a prospective birth cohort, were used. Maternal allergic diseases, including a history of bronchial asthma (BA), atopic dermatitis (AD), and allergic rhinitis (AR), were obtained by self-administered questionnaires. Total serum IgE levels were measured at the first trimester and obstetrical outcomes from medical records transcripts were analyzed. The association between maternal allergic disease and obstetric outcome, including threatened abortion, preterm labor, early preterm birth (22-33 weeks), and late preterm birth (34-36 weeks), were examined by logistic regression. Subgroup analyses were performed by IgE level.
Maternal BA and AR were associated with an increased risk of threatened abortion and preterm labor, but high total IgE level was associated with a decreased risk of preterm labor. There was little difference in associations between allergic disease and threatened abortion and preterm labor by total IgE levels. Although there was no significant association between allergic disease and preterm birth, if total IgE was high, AR was significantly associated with a decreased risk of early preterm birth (adjusted odds ratio, 0.60; 95% confidence interval 0.43-0.86). There was significant evidence for differences associated with total IgE levels (P-values for the interaction of the effects of AD and AR on early preterm birth were 0.039 and 0.015, respectively).
The effect of allergy on preterm birth might differ depending on the total IgE level.
本研究旨在探讨不同总免疫球蛋白 E（IgE）水平下母体过敏与早产之间的关联。
本研究使用了日本环境与儿童研究前瞻性出生队列的 81791 名孕妇的数据。母体过敏性疾病，包括支气管哮喘（BA）、特应性皮炎（AD）和过敏性鼻炎（AR），通过自我管理问卷获得。总血清 IgE 水平在孕早期测量，并从病历转录中分析产科结局。通过逻辑回归检查母体过敏性疾病与产科结局（包括先兆流产、早产、早期早产（22-33 周）和晚期早产（34-36 周））之间的关系。按 IgE 水平进行亚组分析。
母体 BA 和 AR 与先兆流产和早产的风险增加相关，但高总 IgE 水平与早产的风险降低相关。在 IgE 水平的影响下，过敏性疾病与先兆流产和早产之间的关联差异不大。尽管过敏性疾病与早产之间无显著关联，但如果总 IgE 较高，AR 与早期早产的风险降低显著相关（调整后的优势比，0.60；95%置信区间 0.43-0.86）。IgE 水平的影响存在显著差异（AD 和 AR 对早期早产影响的交互作用的 P 值分别为 0.039 和 0.015）。
过敏对早产的影响可能因总 IgE 水平而异。
