The effect of prenatal exposure on total IgE at birth and sensitization at twelve months and four years of age: The PIAMA study

There is increasing evidence that the development of the fetal immune system can be influenced by environmental exposure in utero. We investigated whether prenatal exposure is associated with a high neonatal total IgE level and sensitization at the age of 1 and 4 yr. Data from 1027 infants were collected in a Dutch birth cohort study (PIAMA study). Total IgE was measured in heel prick blood collected in the first week of life. Sensitization was defined as a specific IgE level in serum of > or =0.35 IU/ml against house dust mite, cat, dog, milk or egg. Logistic regression analysis was performed to study independent relationships between risk factors and a high neonatal total IgE (> or =0.50 IU/ml) or sensitization. A high neonatal total IgE was found in 12.2% of boys and 6.2% of girls. A dog at home during pregnancy was negatively associated with a high neonatal total IgE [odds ratio (95% CI) 0.5 (0.2-1.0)]. A cat at home [OR 0.6 (0.4-1.0) and maternal smoking (OR 0.4 (0.2-1.0)] were negatively associated with sensitization at 12 months, but not at 4 yr. The presence of older siblings, season of birth, birth weight, mode of delivery, gestational age and maternal age were not associated with a high neonatal total IgE or sensitization. The higher total IgE level and prevalence of sensitization at 4 yr in boys compared with girls was only present in children from allergic mothers. Our results suggest a short-lasting protective effect of prenatal exposure to pets on total IgE at birth and early sensitization.