Preterm birth reduces the risk of IgE sensitization up to early adulthood: a population-based birth cohort study

Allergy. 2021 Sep 6. doi: 10.1111/all.15077. Online ahead of print.


BACKGROUND: Immunoglobulin E (IgE) sensitization is associated with asthma and allergic diseases. Gestational age influences early immune system development, thereby potentially affecting the process of tolerance induction to allergens.

OBJECTIVE: To study IgE sensitization to common allergens by gestational age from childhood up to early adulthood.

METHODS: Population-based birth cohort, data from the Swedish BAMSE study were used. Allergen-specific IgE to a mix of common food (fx5) and inhalant (Phadiatop) allergens were analysed at 4, 8, 16 and 24 years. Sensitization was defined as allergen-specific IgE ≥0.35 kUA /l to fx5 and/or Phadiatop at each time-point. Using logistic regression and generalized estimated equations, adjusted odds ratios (aORs) for sensitization in relation to gestational age were calculated. Replication was sought within the Swedish twin study STOPPA.

RESULTS: In BAMSE, 3522 participants were screened for IgE antibodies during follow-up; of these, 197 (5.6%) were born preterm (<37 gestational weeks), and 330 (9.4%) post-term (≥42 weeks). Preterm birth reduced the risk of sensitization to common food and/or inhalant allergens up to early adulthood by 29% (overall aOR=0.71; 95% CI: 0.52-0.98), and to food allergens specifically by 40% (overall aOR=0.60; 95% CI: 0.38-0.93). No relation was found between post-term birth and IgE sensitization at any time-point. Replication analyses in STOPPA (N=675) showed similar risk estimates for sensitization to food and/or inhalant allergens (aOR=0.72; 95% CI: 0.42-1.21), which resulted in a combined meta-analysis aOR=0.71 (95% CI: 0.54-0.94).

CONCLUSIONS: Our study suggests an inverse association between preterm birth and long-term IgE sensitization.

PMID:34486741 | DOI:10.1111/all.15077

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