Department of Research & Development, MYOR Diagnostics Limited, Zichron Yaakov, Israel; Department of Statistics, University of Haifa, Haifa, Israel.
Department of Statistics, University of Haifa, Haifa, Israel.
Ann Allergy Asthma Immunol. 2023 Aug;131(2):231-238. doi: 10.1016/j.anai.2023.04.012. Epub 2023 Apr 24.
The Learning Early About Peanut Allergy or LEAP trial found that the early introduction of peanuts in the diet of infants at risk for peanut allergies prevents peanut allergy. The effect of maternal consumption of peanuts on subsequent peanut sensitization or peanut allergy in the LEAP trial has not been studied to date.
To determine whether maternal consumption of peanut protein while breastfeeding protects against peanut-allergic outcomes in the absence of peanut consumption in infants.
We performed an analysis of the data from the peanut avoidance arm of the LEAP study to discern the effects of maternal consumption of peanuts while pregnant and breastfeeding on an infant's peanut-allergic outcomes.
Of the 303 infants in the avoidance group, 31 mothers consumed more than 5 g of peanut per week, 69 consumed less than 5 g of peanut per week and 181 did not consume peanut while breastfeeding. Peanut sensitization (P = .03) and peanut allergy (P = .07) occurred less frequently in infants whose mothers consumed a moderate amount of peanuts while breastfeeding when compared with those who either did not consume peanuts while breastfeeding or those who consumed a large amount of peanuts when breastfeeding. Ethnicity (odds ratio [OR], 0.47; P = .046, 95% confidence interval [CI], 0.22-0.99), baseline peanut skin prick test stratum (OR, 4.87; P < .001, 95% CI, 2.13-11.12), no maternal peanut consumption while breastfeeding (OR, 3.25; P = .008, 95% CI, 1.36-7.77), and baseline SCORing Atopic Dermatitis greater than 40 (OR, 2.78; P = .007, 95% CI, 1.32-5.85) were all significant contributors to peanut sensitization or allergy at 60 months of age.
Moderate consumption (<5 grams per week) of peanuts while breastfeeding provides a significant protective effect against peanut sensitization and a noticeable but not statistically significant protective effect against peanut allergy later on in life in high-risk infants in the context of delayed peanut introduction.
早期食用花生预防过敏或 LEAP 试验发现，在有花生过敏风险的婴儿饮食中早期引入花生可预防花生过敏。迄今为止，尚未研究 LEAP 试验中母亲食用花生对随后婴儿花生致敏或花生过敏的影响。
确定母亲在母乳喂养期间食用花生蛋白是否可以预防婴儿在没有食用花生的情况下出现花生过敏结局。
我们对 LEAP 研究回避组的数据进行了分析，以了解母亲在怀孕期间和母乳喂养期间食用花生对婴儿花生过敏结局的影响。
在回避组的 303 名婴儿中，31 名母亲每周食用超过 5 克花生，69 名母亲每周食用少于 5 克花生，181 名母亲在母乳喂养期间不食用花生。与不食用花生或大量食用花生的母亲相比，母乳喂养时适量食用花生的母亲，其婴儿发生花生致敏（P =.03）和花生过敏（P =.07）的频率较低。种族（比值比 [OR]，0.47；P =.046，95%置信区间 [CI]，0.22-0.99）、基线花生皮试分层（OR，4.87；P <.001，95% CI，2.13-11.12）、母亲在母乳喂养期间不食用花生（OR，3.25；P =.008，95% CI，1.36-7.77）和基线 SCORing 特应性皮炎大于 40（OR，2.78；P =.007，95% CI，1.32-5.85）均是 60 个月时发生花生致敏或过敏的重要因素。
在延迟引入花生的情况下，高危婴儿母乳喂养时适度食用（每周<5 克）花生可显著预防花生致敏，并对以后的花生过敏产生明显但无统计学意义的保护作用。
