Birth-related factors and doctor-diagnosed wheezing and allergic sensitization in early childhood

Allergy. 2010 Sep;65(9):1116-25. doi: 10.1111/j.1398-9995.2009.02322.x. Epub 2010 Jan 28.

Abstract

Background: To investigate the associations between clinical obstetric factors during birth and doctor-diagnosed wheezing and allergic sensitization during early childhood.

Methods: We followed 410 Finnish women from late pregnancy until 18 months age of their children. All children were delivered at term. Doctor-diagnosed wheezing among children was established by questionnaires, while specific immunoglobulin E antibodies to inhalant and food allergens were measured in 388 children at 1 year of age. Data on maternal obstetric variables were recorded at the time of delivery.

Results: Children of mothers with longer duration of ruptured fetal membranes before birth had significantly higher risk of doctor-diagnosed wheezing during early childhood compared to those children with shorter period of ruptured fetal membranes (III vs I quartile; aOR 6.65, 95% CI 1.99-22.18; P < 0.002 and IV vs I quartile; aOR 3.88, 95% CI 1.05-14.36, P < 0.043). Children who were born by Cesarean delivery had significantly less allergic sensitization at the age of 1 year compared to those who were born by vaginal route (16.0%vs 32.2%; aOR 0.34, 95% CI 0.14-0.80; P < 0.013). Furthermore, allergic sensitization tended to be more common in children with longer duration of labor before birth. No other birth-related obstetric factors, such as induction, the type of fetal membrane rupture during birth or quality of amniotic fluid were associated significantly with the examined outcomes.

Conclusion: The longer duration of the ruptured fetal membranes possibly reflected the higher risk of intrapartum infection at birth, and further increased the risk of doctor-diagnosed wheezing among offspring.

MeSH terms

  • Adult
  • Allergens / adverse effects
  • Allergens / immunology
  • Cesarean Section
  • Cohort Studies
  • Delivery, Obstetric / methods*
  • Female
  • Fetal Membranes, Premature Rupture / epidemiology*
  • Finland / epidemiology
  • Food Hypersensitivity / diagnosis
  • Humans
  • Hypersensitivity, Immediate / diagnosis*
  • Hypersensitivity, Immediate / epidemiology
  • Hypersensitivity, Immediate / immunology
  • Immunoglobulin E
  • Infant
  • Infant, Newborn
  • Male
  • Pregnancy
  • Respiratory Sounds / diagnosis*
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Allergens
  • Immunoglobulin E