PURPOSE OF THE STUDY.
The goal of this study was to examine whether prenatal exposure to peanut or sesame seed oil as a vehicle for progesterone injection increases the child’s odds of peanut (PN), tree nut (TN), or sesame seed (SS) allergy.
A total of 1272 food-allergic children were evaluated at Boston Children’s Hospital. Control subjects were children allergic to foods including dairy or eggs but not PN, TNs, or SS. Case subjects included those allergic to PN, TNs, and/or SS.
Parents completed a questionnaire addressing demographic characteristics, family history, child’s history of allergies, use of assisted reproduction, and prenatal exposure to food allergens. The child’s skin prick and specific immunoglobulin E test results were reviewed. Two samples of progesterone suspended in SS oil were assayed for SS protein content during the study.
A total of 1272 questionnaires were analyzed. There were no statistical differences between case subjects and control subjects in demographic characteristics, parental atopy, or birth history. History of parental infertility, in vitro fertilization treatment, progesterone support, and treatment with intramuscular progesterone during pregnancy were not associated with significant differences in the frequency of childhood PN/TN/SS sensitization versus sensitization to other foods. Maternal ingestion of eggs, dairy, or seafood did not increase the odds of PN/TN/SS sensitization in the child; however, ingestion of TN and SS during the first trimester of pregnancy was associated with increased odds of PN/TN/SS sensitization. Maternal PN ingestion during pregnancy was associated with increased odds of PN/TN/SS sensitization in the child.
There was no increase in the prevalence of PN/TN/SS sensitization in children born to parents with a history of infertility or conception with medical assistance with or without progesterone. Maternal ingestion of TN/SS during pregnancy was associated with increased odds of PN/TN/SS sensitization in the child.
The effect of prenatal exposure and possible alterations to the prenatal milieu, such as substances used in fertility treatments, are important questions in addressing the possible causes of the increasing prevalence of food allergy. Limitations of this study include its retrospective nature, possible dietary recall bias, and limited information on the composition of the oil for the progesterone treatments.
- Copyright © 2014 by the American Academy of Pediatrics