Food allergy, anaphylaxis, dermatology, and drug allergy
The risk of developing food allergy in premature or low-birth-weight children

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Background

Premature or low-birth-weight children have increased gut permeability compared with term or normal-birth-weight children.

Objective

To determine whether premature or low-birth-weight children have an increased risk of developing food allergy compared with term or normal-birth-weight children.

Methods

The 1995 Manitoba Birth Cohort was studied using the Manitoba Health Services Insurance Plan (MHSIP) database. This database is a population-based, health care administrative and prescription database. It has records of every child born and subsequent utilization of the provincial health care system. The diagnosis of food allergy (ICD-9-CM code of 693 in hospital/medical claims or a prescription of injectable epinephrine excluding a sole diagnosis of venom allergy) was obtained up until the year 2002. The relative risks of food allergy in premature or low-birth-weight children compared with term or normal-birth-weight children were determined.

Results

A total of 13,980 children were born in 1995 and continue to live in the province of Manitoba. Of these, 592 children (4.23%) were found to have food allergy and epinephrine was prescribed in 316 (2.26%) children. No gestational age or birth weight group had a statistically significant increased risk for food allergy.

Conclusion

Prematurity and low birth weight are not associated with a change in risk for development of food allergy in childhood.

Clinical implications

Immaturity of the gastrointestinal tract or immune response does not seem to change the risk for development of food allergies. We ask whether early exposure to food antigens may protect premature children by increasing immune tolerance to those antigens.

Section snippets

Methods

The Study of Asthma Genes and the Environment (SAGE) is a study focusing on the 1995 Manitoba Birth Cohort. One of its platforms has been to analyze records from the Manitoba Health Services Insurance Plan (MHSIP) database (a population-based, linked health care administrative and prescription database). The complete healthcare records of the 1995 birth cohort, which includes physician visits, hospitalizations, and prescription drugs collected by MHSIP in the provision of universal health

Results

A total of 16,320 children were born in the province of Manitoba in 1995, of which 13,980 (85.7%) continued to live in the province in 2002. A description of these children based on birth weight and gestational age is shown in Table I. Of the 13,980 children, 881 (6.3%) were born prematurely (gestational age <37 weeks). Overall, 691 children (4.9%) were born with a birth weight less than 2500 g. From the total cohort, 592 children (4.23%) were found to have food allergy sometime in their life

Discussion

To the best of our knowledge, this population-based study is the first to examine prematurity or low birth weight and the risk of developing food allergy. Our data suggest that no association exists between gestational age and birth weight with the development of IgE-mediated food allergies. As a result, the theory that an immature gut mucosa results in increased permeability to large-molecular-weight proteins and predisposes the baby to early sensitization needs to be questioned.6, 7, 8, 9, 12

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  • Cited by (0)

    Supported by the Canadian Institutes for Health Research (CIHR), Canadian Allergy, Asthma and Immunology Foundation (CAAIF), Manitoba Institute of Child Health, Biology of Breathing Theme (MICH), and National Training Program in Allergy and Asthma (NTPAA).

    Disclosure of potential conflict of interest: S. I. Huq has received grant support from the Canadian Institute of Health Research. The rest of the authors have declared that they have no conflict of interest.

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