Natural history of food allergy in high-risk infants in a cohort prospective study

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Abstract
BACKGROUND: The problem of food allergy remains actual in pediatric practice. AIM: to establish the prevalence, clinical features and risk factors of food allergy in infants predisposed to allergy diseases in a cohort prospective study with a follow-up period of 12 months. MATERIALS AND METHODS: A prospective cohort study in children whose parents suffer from allergic diseases (n=151) was initiated. Prospective observation included: clinical examination at birth and at the age of 3, 9, 12 months, interviewing parents, assessment of allergen-specific IgE to food allergens in blood serum at the age of 12 months. Statistical analysis was performed using STATISTICA 13.3. RESULTS: 141 children completed the prospective follow-up. Suspected food allergy (reactions associated with the use of food products) was registered in 48.9% of predisposed children. The symptoms of food allergy include skin lesions and gastrointestinal symptoms. Oral allergic syndrome and respiratory symptoms were recorded only in some cases. Prevalence of suspected food allergy progressively increase by 12 months, mainly due to skin symptoms, while the prevalence of gastrointestinal symptoms, on the contrary, decreased by this age. Mixed feeding was recognized as a risk factor for suspected food allergy in predisposed children. The prevalence of IgE ― mediated food allergy, was 13.9%. The use of antibiotics in the first year of life was shown as risk factor for IgE-mediated food allergy in predisposed children. Multivariate logistic regression showed that pets (cats) owners had lower risk of food allergy. CONCLUSION: Primary allergy prevention and adherence to the principles of rational antibiotic therapy is necessary in children predisposed to allergic diseases.

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