Pregnancy Exposure to Colds, Dust Mites and Offspring Atopic Dermatitis, Hayfever

Sabina Illi, Dipl.-Stat., MPH University Children's Hospital Lindwurmstr. 4 80337 Munich GermanyMedicalResearch.com Interview with:
Dr. Sabina Illi, Dipl.-Stat., MPH
University Children’s Hospital
Lindwurmstr. 4
80337 Munich Germany

MedicalResearch.com: What are the main findings of the study?

Answer: We observed that the offspring of atopic pregnant women that showed symptoms of atopy during pregnancy, i.e. atopic dermatitis or hay fever, had a higher risk of having the respective atopic disorder themselves. However, we do not know whether this is due to timing, i.e. pregnancy, or whether it merely mirrors the severity of maternal disease.

Furthermore, in our study pregnant mothers with repeated colds during pregnancy were at increased risk of having a child that wheezed at pre-school age, this was statistically independent of the intake of medication.
We also took dust samples from the child’s home at the early age of 3 months. Interestingly, a contrasting effect of the level of endotoxin from the child’s mattress, a component of the cell-wall of gram-negative bacteria, and of mite allergen exposure was observed in that the lowest risk for mite sensitization at pre-school age was observed in those children with both low mite allergen exposure and high endotoxin exposure.


MedicalResearch.com: Were any of the findings unexpected?

Answer:  Yes, all of our findings are new to some extent.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer:  As long as the immunological mechanisms leading to our findings are not well understood it is hard to give any recommendations to clinicians or patients. In our case, we are not speaking about patients but about pregnant women. Pregnancy comprises a very complex interaction of various immunological factors that are to some part genetically predetermined and to some part influenced by external factors such as environment and infections. Thus, I would strongly refrain from giving any direct advice such as “don’t catch a cold when pregnant”. In a previous study, we observed that repeated episodes of runny nose in the first year of life of the newborn child were protective for wheeze in later in life. So far, these seemingly contrasting observations cannot be explained, as we know too little about the involved immunological processes. I believe our results are fairly preliminary and need confirmation in further studies before any recommendations can be given.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer:  Our study on perinatal factors in the evolution of atopic and asthmatic disorders is an explorative, observational study. It comprises only 526 mothers and has a follow-up period of only 5 years. We have no lab data on immunological factors. Furthermore, we have a quite homogeneous study group with all mothers coming from the fairly affluent region of Greater Munich. I recommend a much larger long-term study that aims at assessing as many environmental, infectious and lifestyle factors in pregnancy as possible. In parallel, immunological factors need be assessed prospectively in order to shed light into the extremely complex immunological processes going on in pregnancy.

Citation:

Perinatal influences on the development of asthma and atopy in childhood

  • Sabina Illi, PhD
  • Juliane Weber, MD,
  • Anne Zutavern, MD,
  • Jon Genuneit, MD,
  • Rudolf Schierl, PhD,
  • Christine Strunz-Lehner, MPH,
  • Erika von Mutius, MD
  • Annals of Allergy, Asthma & Immunology
    • Volume 112, Issue 2, February 2014, Pages 132–139.e1