A prospective birth cohort study of different risk factors for development of allergic diseases in offspring of non-atopic parents

// Ming-Tsung Lee 1 , Chih-Chiang Wu 2,3 , Chia-Yu Ou 3 , Jen-Chieh Chang 4 , Chieh-An Liu 3 , Chih-Lu Wang 3 , Hau Chuang 4,5 , Ho-Chang Kuo 4,5 , Te-Yao Hsu 6,7 , Chie-Pein Chen 8 and Kuender D. Yang 2,8,9,10 1 Research Assistant Center, Show Chwan Memorial Hospital, Changhua, Taiwan 2 Institute of Clinical Medicine, National Yang-Ming University, Taiwan 3 Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan 4 Departments of Pediatrics and Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 5 Chang Gung University College of Medicine, Kaohsiung, Taiwan 6 Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Taiwan 7 Chang Gung University College of Medicine, Kaohsiung, Taiwan 8 Department of Medical Research, MacKay Memorial Hospital, Taipei 9 Department of Pediatrics, MacKay Memorial Hospital, Taipei 10 Institute of Biomedical Sciences, MacKay Medical College, New Taipei, Taiwan Correspondence to: Kuender D. Yang, email: // Te-Yao Hsu, email: // Keywords : birth cohort, atopic dermatitis, allergic rhinitis, asthma, perinatal environment Received : October 22, 2016 Accepted : December 26, 2016 Published : January 09, 2017 Abstract Background: Allergic diseases are thought to be inherited. Prevalence of allergic diseases has, however, increased dramatically in last decades, suggesting environmental causes for the development of allergic diseases. Objective: We studied risk factors associated with the development of atopic dermatitis (AD), allergic rhinitis (AR) and asthma (AS) in children of non-atopic parents in a subtropical country. Methods: In a birth cohort of 1,497 newborns, parents were prenatally enrolled and validated for allergic diseases by questionnaire, physician-verified and total or specific Immunoglobulin E (IgE) levels; 1,236 and 756 children, respectively, completed their 3-year and 6-year follow-up. Clinical examination, questionnaire, and blood samples for total and specific IgE of the children were collected at each follow-up visit. Results: Prevalence of AD, AR and AS was, respectively, 8.2%, 30.8% and 12.4% in children of non-atopic parents. Prevalence of AR ( p <.001) and AS ( p =.018) was significantly higher in children of parents who were both atopic. A combination of Cesarean section (C/S) and breastfeeding for more than 1 month showed the highest risk for AD (OR=3.111, p =.006). Infants living in homes with curtains and no air filters had the highest risk for AR (OR=2.647, p <.001), and male infants of non-atopic parents living in homes without air filters had the highest risk for AS (OR=1.930, p =.039). Conclusions: Breastfeeding and C/S affect development of AD. Gender, use of curtains and/or air filters affect AR and AS, suggesting that control of the perinatal environment is necessary for the prevention of atopic diseases in children of non-atopic parents.