Research
Antenatal risk factors for peanut allergy in children
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* Corresponding author: Karen E Binkley binkleyk@smh.ca
1 Division of Clinical Immunology and Allergy, Department of Medicine, St. Michael's Hospital University of Toronto, Toronto, Ontario, Canada
2 Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
3 Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
4 Department of Medicine, St. Michael's Hospital University of Toronto, Toronto, Ontario, Canada
5 Department of Obstetrics and Gynecology, St. Michael's Hospital University of Toronto, Toronto, Ontario, Canada
6 Department of Health Policy Management and Evaluation St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Allergy, Asthma & Clinical Immunology 2011, 7:17 doi:10.1186/1710-1492-7-17
Published: 4 October 2011Abstract
Background
Prenatal factors may contribute to the development of peanut allergy. We evaluated the risk of childhood peanut allergy in association with pregnancy exposure to Rh immune globulin, folic acid and ingestion of peanut-containing foods.
Methods
We conducted a web-based case-control survey using the Anaphylaxis Canada Registry, a pre-existing database of persons with a history of anaphylaxis. A total of 1300 case children with reported peanut allergy were compared to 113 control children with shellfish allergy. All were evaluated for maternal exposure in pregnancy to Rh immune globulin and folic acid tablet supplements, as well as maternal avoidance of dietary peanut intake in pregnancy.
Results
Receipt of Rh immune globulin in pregnancy was not associated with a higher risk of peanut allergy (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.51 to 1.45), nor was initiation of folic acid tablet supplements before or after conception (OR 0.53, 95% CI 0.19 to 1.48). Complete avoidance of peanut-containing products in pregnancy was associated with a non-significantly lower risk of peanut allergy (OR 0.53, 95% CI 0.27 to 1.03).
Conclusion
The risk of childhood peanut allergy was not modified by the following common maternal exposures in pregnancy: Rh immune globulin, folic acid or peanut-containing foods.
Clinical implications
Rh immune globulin, folic acid supplement use and peanut avoidance in pregnancy have yet to be proven to modulate the risk of childhood anaphylaxis to peanuts.
Capsule Summary
Identification of prenatal factors that contribute to peanut allergy might allow for prevention of this life-threatening condition. This article explores the role of three such factors.