Dataset Information

Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants.

ABSTRACT:

Background

Peanut allergy is typically severe, lifelong, and prevalent.

Objective

To identify factors associated with peanut sensitization.

Methods

We evaluated 503 infants 3 to 15 months of age (mean, 9.4 months) with likely milk or egg allergy but no previous diagnosis of peanut allergy. A total of 308 had experienced an immediate allergic reaction to cow's milk and/or egg, and 204 had moderate to severe atopic dermatitis and a positive allergy test to milk and/or egg. A peanut IgE level ?5 kU(A)/L was considered likely indicative of peanut allergy.

Results

A total of 140 (27.8%) infants had peanut IgE levels ?5 kU(A)/L. Multivariate analysis including clinical, laboratory, and demographic variables showed frequent peanut consumption during pregnancy (odds ratio, 2.9; 95% CI, 1.7-4.9; P < .001), IgE levels to milk (P = .001) and egg (P < .001), male sex (P = .02), and nonwhite race (P = .02) to be the primary factors associated with peanut IgE ?5 kUA/L. Frequency of peanut consumption during pregnancy and breast-feeding showed a dose-response association with peanut IgE ?5 kU(A)/L, but only consumption during pregnancy was a significant predictor. Among 71 infants never breast-fed, frequent consumption of peanut during pregnancy was strongly associated with peanut IgE ?5 kU(A)/L (odds ratio, 4.99, 95% CI, 1.69-14.74; P < .004).

Conclusion

In this cohort of infants with likely milk or egg allergy, maternal ingestion of peanut during pregnancy was strongly associated with a high level of peanut sensitization.

SUBMITTER: Sicherer SH

PROVIDER: S-EPMC3018157 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants.

Sicherer Scott H SH Wood Robert A RA Stablein Donald D Lindblad Robert R Burks A Wesley AW Liu Andrew H AH Jones Stacie M SM Fleischer David M DM Leung Donald Y M DY Sampson Hugh A HA

The Journal of allergy and clinical immunology 20101028 6

<h4>Background</h4>Peanut allergy is typically severe, lifelong, and prevalent.<h4>Objective</h4>To identify factors associated with peanut sensitization.<h4>Methods</h4>We evaluated 503 infants 3 to 15 months of age (mean, 9.4 months) with likely milk or egg allergy but no previous diagnosis of peanut allergy. A total of 308 had experienced an immediate allergic reaction to cow's milk and/or egg, and 204 had moderate to severe atopic dermatitis and a positive allergy test to milk and/or egg. A ...[more]

PMID: 21035177

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Project description:ImportanceEarly peanut introduction reduces the risk of developing peanut allergy, especially in high-risk infants. Current US recommendations endorse screening but are not cost-effective relative to other international strategies.ObjectiveTo identify scenarios in which current early peanut introduction guidelines would be cost-effective.Design, setting, and participantsThis simulation/cohort economic evaluation used microsimulations and cohort analyses in a Markov model to evaluate the cost-effectiveness of early peanut introduction with and without peanut skin prick test (SPT) screening in high-risk infants during an 80-year horizon from a societal perspective. Data were analyzed from April to May 2019.ExposuresHigh-risk infants with early-onset eczema and/or egg allergy underwent early peanut introduction with and without peanut SPT screening (100?000 infants per treatment strategy) using a dichotomous 8-mm SPT cutoff value (stipulated in the current US guideline).Main outcomes and measuresCost, quality-adjusted life-years (QALYs), net monetary benefit, peanut allergic reactions, severe allergic reactions, and deaths due to peanut allergy.ResultsIn the simulated cohort of 200 000 infants and using the base case during the model horizon, a no-screening approach had lower mean (SD) costs ($13?449 [$38?163] vs $15?279 [$38?995]) and higher mean (SD) gain in QALYs (29.25 [3.28] vs 29.23 [3.30]) vs screening but resulted in more allergic reactions (mean [SD], 1.07 [3.15] vs 1.01 [3.02]), severe allergic reactions (mean [SD], 0.53 [1.66] vs 0.52 [1.62]), and anaphylaxis involving cardiorespiratory compromise (mean [SD], 0.50 [1.59] vs 0.49 [1.47]) per individual. In deterministic SPT sensitivity analyses at base-case sensitivity and specificity rates, screening could be cost-effective at a high disutility rate (the negative effect of a food allergic reaction) (76-148 days of life traded) for an at-home vs in-clinic reaction in combination with high baseline peanut allergy prevalence among infants at high risk for peanut allergy and not yet exposed to peanuts. If an equivalent rate and disutility of accidental and index anaphylaxis was assumed and the 8-mm SPT cutoff had 0.85 sensitivity and 0.98 specificity, screening was cost-effective at a peanut allergy prevalence of 36%.Conclusions and relevanceThe results of this study suggest that the current screening approach to early peanut introduction could be cost-effective at a particular health utility for an in-clinic reaction, SPT sensitivity and specificity, and high baseline peanut allergy prevalence among high-risk infants. However, such conditions are unlikely to be plausible to realistically achieve. Further research is needed to define the health state utility associated with reaction location.

Dataset Information

Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants.

Background

Objective

Methods

Results

Conclusion

Publications

Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants.

Similar Datasets

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