Gestational diabetes, atopic dermatitis, and allergen sensitization in early childhood

Rajesh Kumar, Fengxiu Ouyang, Rachel E. Story, Jacqueline A. Pongracic, Xiumei Hong, Guoying Wang, Colleen Pearson, Kathryn Ortiz, Howard Bauchner, Xiaobin Wang

Research output: Contribution to journalArticle

Abstract

Background: The relationship between the prenatal environment, maternal-fetal interaction, and allergic disease in the offspring remains understudied. Objective: We sought to determine whether gestational diabetes (GDM) modifies the risk of early childhood atopic manifestations, including atopic dermatitis and allergen sensitization. Methods: This study includes 680 children from the Boston Birth Cohort. Mother-child dyads were recruited at birth and followed prospectively to a mean age of 3.2 ± 2.3 years, with study visits aligned with the pediatric primary care schedule. The primary outcomes were physician-diagnosed atopic dermatitis on standardized medical record abstraction and allergen sensitization based on ImmunoCAP to 7 common foods and 5 common aeroallergens (specific IgE, ≥0.10 kUA/L; Phadia, Uppsala, Sweden). GDM was determined by means of standardized medical record review. Logistic regression analysis, stratified by term/preterm status, evaluated the association of GDM with atopic dermatitis and allergen sensitization, respectively, controlling for maternal prepregnancy body mass index, fetal growth, and pertinent covariates. Results: Of the 680 children, 488 were term, and 192 were preterm (<37 weeks' gestation). Overall, 4.9% of the mothers had GDM. Among the 680 children, 34.4% had atopic dermatitis, and 51% had allergen sensitization. In term births GDM was significantly associated with atopic dermatitis (odds ratio [OR], 7.2; 95% CI, 1.5-34.5) and allergen sensitization (OR, 5.7; 95% CI, 1.2-28.0). Adjusting for fetal growth had little effect. The association with sensitization was driven primarily by food sensitization (OR, 8.3; 95% CI, 1.6-43.3). The above associations were not observed in preterm births. Conclusions: In term births GDM increased the risk of atopic dermatitis and early childhood allergen sensitization independently of maternal prepregnancy body mass index and fetal growth.

Original languageEnglish (US)
Pages (from-to)1031-1038.e4
JournalJournal of Allergy and Clinical Immunology
Volume124
Issue number5
DOIs
StatePublished - Nov 2009
Externally publishedYes

Keywords

  • Atopic dermatitis
  • eczema
  • food allergen sensitization
  • gestational diabetes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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