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Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk.

Abstract

OBJECTIVES

To assess the effects of prescribing an antigen avoidance diet during pregnancy on the nutritional status of the mother and newborn and on the development of atopic disease in the child. The main focus is on women at high risk for giving birth to an atopic child, based on a history of atopic disease in the mother, father, or a previous child.

SEARCH STRATEGY

The register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group.

SELECTION CRITERIA

All acceptably controlled comparisons of maternal antigen avoidance prescribed to pregnant women at high risk, regardless of the degree of antigen avoidance (number of foods eliminated from the diet) or the time of its onset during pregnancy. Data are also included on formula-fed (ie non-breastfed) infants in trials of maternal antigen avoidance intended to continue beyond pregnancy into the lactation period.

DATA COLLECTION AND ANALYSIS

Data were extracted by the author from published reports, and supplemented by additional information from trialists contacted by the author.

MAIN RESULTS

Three trials involving 504 women were included. Based on the single trial providing pertinent data, the restricted diet was associated with a small but statistically significant lower mean gestational weight gain (mean difference = -3.0% of prepregnancy weight) and a nonsignificantly higher risk of preterm birth. The combined evidence does not suggest a strong protective effect of maternal antigen avoidance on the incidence of atopic eczema or asthma during the first 12-18 months of life. Data on allergic rhinitis/conjuctivitis and urticaria are limited to a single trial each and are insufficient to draw meaningful inferences. Two trials suggest a lower incidence of skin prick tests to egg at 6 months of age, but the effect was no longer evident at 18 months, nor was any benefit apparent at either age for skin prick tests to milk. If anything, cord blood IgE levels were higher in the experimental (antigen avoidance) group.

REVIEWER'S CONCLUSIONS

Prescription of an antigen avoidance diet to a high-risk woman during pregnancy is unlikely to reduce substantially her risk of giving birth to an atopic child. Moreover, such a diet may have an adverse effect on maternal and/or fetal nutrition.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montreal, Quebec, Canada, H3A 1A2. mikek@epid.lan.mcgill.ca

    Source

    MeSH

    Dietary Proteins
    Female
    Humans
    Hypersensitivity, Immediate
    Infant, Newborn
    Pregnancy
    Risk Factors

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    10796150

    Citation

    Kramer, M S.. "Maternal Antigen Avoidance During Pregnancy for Preventing Atopic Disease in Infants of Women at High Risk." The Cochrane Database of Systematic Reviews, 2000, p. CD000133.
    Kramer MS. Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk. Cochrane Database Syst Rev. 2000.
    Kramer, M. S. (2000). Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk. The Cochrane Database of Systematic Reviews, (2), p. CD000133.
    Kramer MS. Maternal Antigen Avoidance During Pregnancy for Preventing Atopic Disease in Infants of Women at High Risk. Cochrane Database Syst Rev. 2000;(2)CD000133. PubMed PMID: 10796150.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk. A1 - Kramer,M S, PY - 2000/5/5/pubmed PY - 2000/7/8/medline PY - 2000/5/5/entrez SP - CD000133 EP - CD000133 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 2 N2 - OBJECTIVES: To assess the effects of prescribing an antigen avoidance diet during pregnancy on the nutritional status of the mother and newborn and on the development of atopic disease in the child. The main focus is on women at high risk for giving birth to an atopic child, based on a history of atopic disease in the mother, father, or a previous child. SEARCH STRATEGY: The register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group. SELECTION CRITERIA: All acceptably controlled comparisons of maternal antigen avoidance prescribed to pregnant women at high risk, regardless of the degree of antigen avoidance (number of foods eliminated from the diet) or the time of its onset during pregnancy. Data are also included on formula-fed (ie non-breastfed) infants in trials of maternal antigen avoidance intended to continue beyond pregnancy into the lactation period. DATA COLLECTION AND ANALYSIS: Data were extracted by the author from published reports, and supplemented by additional information from trialists contacted by the author. MAIN RESULTS: Three trials involving 504 women were included. Based on the single trial providing pertinent data, the restricted diet was associated with a small but statistically significant lower mean gestational weight gain (mean difference = -3.0% of prepregnancy weight) and a nonsignificantly higher risk of preterm birth. The combined evidence does not suggest a strong protective effect of maternal antigen avoidance on the incidence of atopic eczema or asthma during the first 12-18 months of life. Data on allergic rhinitis/conjuctivitis and urticaria are limited to a single trial each and are insufficient to draw meaningful inferences. Two trials suggest a lower incidence of skin prick tests to egg at 6 months of age, but the effect was no longer evident at 18 months, nor was any benefit apparent at either age for skin prick tests to milk. If anything, cord blood IgE levels were higher in the experimental (antigen avoidance) group. REVIEWER'S CONCLUSIONS: Prescription of an antigen avoidance diet to a high-risk woman during pregnancy is unlikely to reduce substantially her risk of giving birth to an atopic child. Moreover, such a diet may have an adverse effect on maternal and/or fetal nutrition. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/10796150/Maternal_antigen_avoidance_during_pregnancy_for_preventing_atopic_disease_in_infants_of_women_at_high_risk_ L2 - https://doi.org/10.1002/14651858.CD000133 DB - PRIME DP - Unbound Medicine ER -