Development of atopic disease in relation to family history and cord blood IgE levels

The cumulative incidence of atopic disease from birth to about 11 yr of age and the prevalence during the 11th year was investigated in a cohort of 1654 non‐selected children by an evaluated questionnaire. The total cumulative incidence of obvious atopic disease was 32. 5%, of bronchial asthma 5. 3%, and allergic rhinoconjunctivitis 14. 4%. The prevalence of itopic disease was 23. 7%. Obvious atopic disease developed in 67% of children with cord blood IgE ≥ 0.9 kU/l and a further 15% developed probable atopic disease. The positive predictive value of a family history of atopic disease was 45%. Children with a high cord blood IgE had a 5‐fold increased risk for developing bronchial asthma. The sensitivity of cord blood IgE determination using 0.9 kU/l as cut‐off was only 26%. Therefore, it can not without modifications be recommended as a single screening test. Neonatal IgE determination is., however, suitable, if used in conjunction with the family history, for identifying candidates at high risk for early development of atopic disease, e. g. for evaluation of the effect of preventive measures. Parents tend to forget symptoms (25%) that their children presented some years ago. Questionnaires are thus more suitable for establishing prevalence compared with cumulative rate of atopic disease.