Sugiura Shiro, Hiramitsu Yoshimichi, Futamura Masaki, Kamioka Naomi, Yamaguchi Chikae, Umemura Harue, Ito Komei, Camargo Carlos A
Committee for the Prevention of Pediatric Allergic Disease, Nagoya City, Japan.
Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Asia Pac Allergy. 2021 Jan 22;11(1):e5. doi: 10.5415/apallergy.2021.11.e5. eCollection 2021 Jan.
Identification of risk factors for food allergy (FA) in infants is an active research area. An important reason is to identify optimal target infants for early introduction of specific food antigens. Although eczema has been used for this purpose, multivariable prediction scores have not been reported.
The aim of this research is to develop a multivariable prediction score for infants at high risk of FA.
We performed a cross-sectional analysis of a self-administered questionnaire for the parents of 18-month-old children at well-child visits between April 2016 and March 2017 (development dataset) and between April 2017 and March 2018 (validation dataset). We developed and validated the prediction score.
The questionnaire collection rate was 18,549 of 20,198 (92%) in the development dataset and 18,620 of 19,977 (93%) in the validation dataset. Risk factors for FA were being born in August-December, first child, eczema, atopic dermatitis in father and mother, and FA in mother and sibling(s). For identifying infants with FA, the developed multivariable prediction score showed higher discrimination ability (area under the curve [AUC] = 0.75) than focusing on eczema (AUC = 0.70) in the validation dataset. The score was also useful for identifying infants with a history of anaphylaxis (AUC = 0.73) than focusing on eczema (AUC = 0.67) in the validation dataset.
The new prediction score enables more efficient identification of infants at high risk of FA, who may be the optimal target group for the early introduction of specific antigens.
识别婴儿食物过敏（FA）的风险因素是一个活跃的研究领域。一个重要原因是确定早期引入特定食物抗原的最佳目标婴儿。虽然湿疹已被用于此目的，但多变量预测评分尚未见报道。
本研究旨在为FA高危婴儿开发一种多变量预测评分。
我们对2016年4月至2017年3月（开发数据集）以及2017年4月至2018年3月（验证数据集）健康儿童访视时18个月大儿童的父母自行填写的问卷进行了横断面分析。我们开发并验证了预测评分。
开发数据集中问卷收集率为20198份中的18549份（92%），验证数据集中为19977份中的18620份（93%）。FA的风险因素包括8 - 12月出生、头胎、湿疹、父母患有特应性皮炎以及母亲和兄弟姐妹患有FA。在验证数据集中，对于识别FA婴儿，所开发的多变量预测评分显示出比单纯关注湿疹更高的辨别能力（曲线下面积[AUC]=0.75）（AUC = 0.70）。在验证数据集中，该评分对于识别有过敏反应史的婴儿也比单纯关注湿疹更有用（AUC = 0.73）（AUC = 0.67）。
新的预测评分能够更有效地识别FA高危婴儿，这些婴儿可能是早期引入特定抗原的最佳目标群体。
