Shirakawa T, Morimoto K, Sasaki S, Taniguchi K, Motonaga M, Akahori W, Akahori S, Akahori T, Ohmori H, Kuroda E, Okabe K, Yugari K, Yamana M
Department of Hygiene and Preventive Medicine, School of Medicine, Osaka University, Japan.
Eur J Epidemiol. 1997 Jun;13(4):395-402. doi: 10.1023/a:1007361013917.
During recent decades much interest has been focused on the possibility of predicting and preventing atopic diseases during pregnancy. The idea of being able to detect a predisposition early and take suitable environmental measures in order to avoid overt allergy is an attractive position. Elevated cord IgE of around 1.0 IU/ml has been proposed as a predictor in western children. However, there remains no information about the effect of maternal lifestyle during pregnancy on these levels. Total IgE levels were therefore determined using Pharmacia CAP system and PRIST, with sensitivities of 0.01 kU/l and 0.25 kU/l, respectively, from serum samples taken from 1138 Japanese pairs of cord blood and pregnant women responding to a questionnaire regarding 17 health practices, intake of 32 food allergens and 5 environmental factors. Of these, 28 (2.5%) pairs of samples were excluded from further analysis because of high contamination of IgA (> 15.4 mg/ml) in cord blood. Median cord blood IgE was 0.286 kU/l and geometric mean IgE was 66.25 kU/l in maternal sera using CAP system; there was no significant correlation between maternal log (IgE) and cord blood IgE. Similar results were obtained from PRIST, whose correlation with CAP system was significant (r = 0.884, p < 0.001 for maternal and r = 0.765, p < 0.001 for cord blood). Multiple logistic analysis demonstrated that avoidance of simultaneous exposure to hens' eggs and cow's milk (relative risk = 1.3, p < 0.05) as well as soy beans (relative risk = 2.8, p < 0.01) should be advised to mothers with positive allergic histories and/or high total IgE (> 400 IU/ml), especially in women aged more than 35 years who are pregnant with a male child. However, maintenance of healthy lifestyles, especially taking proper exercise and sleeping, and avoidance of inhalant allergens during late pregnancy may be a more important strategy for the reduction of cord blood IgE levels.
近几十年来,人们对孕期预测和预防过敏性疾病的可能性极为关注。能够早期检测出易感性并采取适当的环境措施以避免明显过敏的想法很有吸引力。在西方儿童中,脐带血IgE水平高于1.0 IU/ml被认为是一个预测指标。然而,关于孕期母亲生活方式对这些水平的影响尚无相关信息。因此,使用Pharmacia CAP系统和PRIST测定了总IgE水平,其灵敏度分别为0.01 kU/l和0.25 kU/l,样本来自1138对日本脐带血和孕妇,这些孕妇回答了一份关于17种健康行为、32种食物过敏原摄入情况和5种环境因素的问卷。其中,28对(2.5%)样本因脐带血中IgA污染严重(> 15.4 mg/ml)而被排除在进一步分析之外。使用CAP系统时,脐带血IgE中位数为0.286 kU/l,母亲血清中IgE几何平均数为66.25 kU/l;母亲log(IgE)与脐带血IgE之间无显著相关性。PRIST也得到了类似结果,其与CAP系统的相关性显著(母亲样本r = 0.884,p < 0.001;脐带血样本r = 0.765,p < 0.001)。多因素逻辑分析表明,对于有阳性过敏史和/或总IgE水平高(> 400 IU/ml)的母亲,尤其是35岁以上怀男婴的孕妇,建议避免同时接触鸡蛋和牛奶(相对风险 = 1.3,p < 0.05)以及大豆(相对风险 = 2.8,p < 0.01)。然而,保持健康的生活方式,尤其是进行适当运动和睡眠,以及在妊娠晚期避免吸入性过敏原,可能是降低脐带血IgE水平更重要的策略。