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Risk factors for hen's egg Allergy in Europe: EuroPrevall Birth Cohort

Risk factors for hen's egg Allergy in Europe: EuroPrevall Birth Cohort
Risk factors for hen's egg Allergy in Europe: EuroPrevall Birth Cohort

BACKGROUND: Hen's egg is one of the commonest causes of food allergy but there are little data on its risk factors.

OBJECTIVE: To assess the risk factors, particularly eczema, for hen's egg allergy in the EuroPrevall birth cohort.

METHODS: In the pan-European EuroPrevall birth cohort, questionnaires were undertaken at 12 and 24 months or when parents reported symptoms. Children with suspected egg allergy were invited for skin prick testing, specific IgE assessment and double-blind, placebo-controlled food challenge (DBPCFC) as indicated. Each egg allergy case (positive DBPCFC or egg induced anaphylaxis) was allocated up to two age- and country-matched controls.

RESULTS: 12,049 were recruited into the EuroPrevall birth cohort. 9,336 (77.5%) were followed until 2 years. 86 infants had egg allergy (84 by DBPCFC) and were matched with 140 controls. Independently associated with egg allergy were past/current eczema (adjusted OR 9.21, 95% confidence interval 2.65-32.04), SCORAD (1.54 per 5 units, 1.28-1.86), antibiotics in the first week of life (6.17, 1.42-26.89) and current rhinitis (3.02, 1.04-8.78). Increasing eczema severity was associated with an increasing likelihood of egg allergy. Eczema was reported to have started 3.6 (SE 0.5) months before egg allergy. Age of introduction of egg into the diet was not associated with egg allergy.

CONCLUSIONS: Similar to peanut allergy, eczema was strongly associated with egg allergy development and the association increased with increasing eczema severity. The age of introduction of dietary egg was not a risk factor. The potential role of antibiotics in early life as a risk factor for egg allergy needs further examination.

Eczema, Food allergy, Hen's egg, Infants, Prevention, Risk factors
1341-1348.e5
Grimshaw, Kate E.C.
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Roberts, Graham
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Selby, Anna
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Reich, Andreas
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Butiene, Indra
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Clausen, Michael
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Dubakiene, Ruta
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Fiandor, Ana
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Fiocchi, Alessandro
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Grabenhenrich, Linus B.
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Larco, Jose Ignacio
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Kowalski, Marek L.
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Rudzeviciene, Odilija
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Papadopoulos, Nikolaos G.
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Rosenfeld, Leonard
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Sigurdardottir, Sigurveig Th
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Sprikkelman, Aline B.
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Schoemaker, Ana A.
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Xepapadaki, Paraskevi
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Mills, E.N. Clare
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Keil, Thomas
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Beyer, Kirsten
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Grimshaw, Kate E.C.
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Roberts, Graham
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Selby, Anna
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Reich, Andreas
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Butiene, Indra
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Clausen, Michael
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Dubakiene, Ruta
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Fiandor, Ana
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Fiocchi, Alessandro
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Grabenhenrich, Linus B.
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Larco, Jose Ignacio
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Kowalski, Marek L.
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Rudzeviciene, Odilija
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Papadopoulos, Nikolaos G.
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Rosenfeld, Leonard
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Sigurdardottir, Sigurveig Th
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Sprikkelman, Aline B.
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Schoemaker, Ana A.
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Xepapadaki, Paraskevi
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Mills, E.N. Clare
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Keil, Thomas
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Beyer, Kirsten
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Grimshaw, Kate E.C., Roberts, Graham, Selby, Anna, Reich, Andreas, Butiene, Indra, Clausen, Michael, Dubakiene, Ruta, Fiandor, Ana, Fiocchi, Alessandro, Grabenhenrich, Linus B., Larco, Jose Ignacio, Kowalski, Marek L., Rudzeviciene, Odilija, Papadopoulos, Nikolaos G., Rosenfeld, Leonard, Sigurdardottir, Sigurveig Th, Sprikkelman, Aline B., Schoemaker, Ana A., Xepapadaki, Paraskevi, Mills, E.N. Clare, Keil, Thomas and Beyer, Kirsten (2020) Risk factors for hen's egg Allergy in Europe: EuroPrevall Birth Cohort. The Journal of Allergy and Clinical immunology: In Practice, 8 (4), 1341-1348.e5. (doi:10.1016/j.jaip.2019.11.040).

Record type: Article

Abstract

BACKGROUND: Hen's egg is one of the commonest causes of food allergy but there are little data on its risk factors.

OBJECTIVE: To assess the risk factors, particularly eczema, for hen's egg allergy in the EuroPrevall birth cohort.

METHODS: In the pan-European EuroPrevall birth cohort, questionnaires were undertaken at 12 and 24 months or when parents reported symptoms. Children with suspected egg allergy were invited for skin prick testing, specific IgE assessment and double-blind, placebo-controlled food challenge (DBPCFC) as indicated. Each egg allergy case (positive DBPCFC or egg induced anaphylaxis) was allocated up to two age- and country-matched controls.

RESULTS: 12,049 were recruited into the EuroPrevall birth cohort. 9,336 (77.5%) were followed until 2 years. 86 infants had egg allergy (84 by DBPCFC) and were matched with 140 controls. Independently associated with egg allergy were past/current eczema (adjusted OR 9.21, 95% confidence interval 2.65-32.04), SCORAD (1.54 per 5 units, 1.28-1.86), antibiotics in the first week of life (6.17, 1.42-26.89) and current rhinitis (3.02, 1.04-8.78). Increasing eczema severity was associated with an increasing likelihood of egg allergy. Eczema was reported to have started 3.6 (SE 0.5) months before egg allergy. Age of introduction of egg into the diet was not associated with egg allergy.

CONCLUSIONS: Similar to peanut allergy, eczema was strongly associated with egg allergy development and the association increased with increasing eczema severity. The age of introduction of dietary egg was not a risk factor. The potential role of antibiotics in early life as a risk factor for egg allergy needs further examination.

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More information

Accepted/In Press date: 25 November 2019
e-pub ahead of print date: 14 December 2019
Published date: April 2020
Keywords: Eczema, Food allergy, Hen's egg, Infants, Prevention, Risk factors

Identifiers

Local EPrints ID: 439491
URI: http://eprints.soton.ac.uk/id/eprint/439491
PURE UUID: 0160b0c2-86f0-4e52-8f9c-b9d37e8bbf3b
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 24 Apr 2020 16:30
Last modified: 30 Jun 2022 01:40

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Contributors

Author: Graham Roberts ORCID iD
Author: Anna Selby
Author: Andreas Reich
Author: Indra Butiene
Author: Michael Clausen
Author: Ruta Dubakiene
Author: Ana Fiandor
Author: Alessandro Fiocchi
Author: Linus B. Grabenhenrich
Author: Jose Ignacio Larco
Author: Marek L. Kowalski
Author: Odilija Rudzeviciene
Author: Nikolaos G. Papadopoulos
Author: Leonard Rosenfeld
Author: Sigurveig Th Sigurdardottir
Author: Aline B. Sprikkelman
Author: Ana A. Schoemaker
Author: Paraskevi Xepapadaki
Author: E.N. Clare Mills
Author: Thomas Keil
Author: Kirsten Beyer

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