{"title":"A web-based questionnaire to evaluate risk factors to develop cow milk allergy.","authors":"Meltem Dinleyici, Koray Harmanci, Didem Arslantas, Yvan Vandenplas, Ener Cagri Dinleyici","doi":"10.1007/s00431-025-06070-3","DOIUrl":null,"url":null,"abstract":"<p><p>Many environmental, genetic, and epigenetic variables are considered to influence the evolution of cow's milk allergy (CMA). The gastro-intestinal microbiota may play a direct role in or inhibit tolerance development. In this study, we planned to evaluate the presence of previously identified risk factors for microbiota composition. This study used a cross-sectional electronic survey in Turkiye, utilizing a national convenience sample of 270 children with CMA, as reported by their caregivers, and 2154 healthy controls. We developed a web-based questionnaire to gather information on pregnancy and maternal-related factors, delivery mode, feeding patterns, antibiotic use, and the presence of pets in the home. The risk factors affecting CMA were maternal age (OR 0.897; 0.862-0.934, p < 0.01), presence of maternal allergic disorders (OR 3.070; 1.891-4.983, p < 0.001) and in both parents (OR 3.831; 1.202-12.210, p < 0.001), maternal weight at conception (OR 1.016; 1.003-1.030, p < 0.05), maternal weight gain during pregnancy (OR 1.033; 1.012-1.056, p < 0.01), (absence of a) pet at home (OR 1.394; 1.003-1.938, p < 0.05), intrapartum antibiotic use (OR 1.469; 1.092-1.975, p < 0.05), antibiotic use during the first 6 months of life (OR 1.933; 1.306-2.863, p < 0.001), and number of householders (OR 0.794; 0.650-0.969, p < 0.05).</p><p><strong>Conclusion: </strong>In addition to allergic disorders in parents, maternal weight and weight gain during pregnancy, intrapartum and first 6 months of life antibiotic use, and the presence of pets at home were found to be microbiota-related risk factors in children with CMA. Potential strategies related to microbiota composition may contribute positively to the disease's development and progression.</p><p><strong>What is known: </strong>• The gut microbiome contributes to the development of cow milk allergy, and disrupted microbiota maturation during the first year of life appears to be common in pediatric food allergies. • Factors that influence an infant's microbiota within the first 1000 days and the relationship between these factors and microbiota may enhance allergy diagnosis, prevention, and treatment.</p><p><strong>What is new: </strong>• Besides parental allergy disorders, maternal weight and weight gain during pregnancy, antibiotic use during intrapartum and first six months of life, and the presence of pets at home were identified as microbiota-related risk factors in children with CMA.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"250"},"PeriodicalIF":3.0000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00431-025-06070-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Many environmental, genetic, and epigenetic variables are considered to influence the evolution of cow's milk allergy (CMA). The gastro-intestinal microbiota may play a direct role in or inhibit tolerance development. In this study, we planned to evaluate the presence of previously identified risk factors for microbiota composition. This study used a cross-sectional electronic survey in Turkiye, utilizing a national convenience sample of 270 children with CMA, as reported by their caregivers, and 2154 healthy controls. We developed a web-based questionnaire to gather information on pregnancy and maternal-related factors, delivery mode, feeding patterns, antibiotic use, and the presence of pets in the home. The risk factors affecting CMA were maternal age (OR 0.897; 0.862-0.934, p < 0.01), presence of maternal allergic disorders (OR 3.070; 1.891-4.983, p < 0.001) and in both parents (OR 3.831; 1.202-12.210, p < 0.001), maternal weight at conception (OR 1.016; 1.003-1.030, p < 0.05), maternal weight gain during pregnancy (OR 1.033; 1.012-1.056, p < 0.01), (absence of a) pet at home (OR 1.394; 1.003-1.938, p < 0.05), intrapartum antibiotic use (OR 1.469; 1.092-1.975, p < 0.05), antibiotic use during the first 6 months of life (OR 1.933; 1.306-2.863, p < 0.001), and number of householders (OR 0.794; 0.650-0.969, p < 0.05).
Conclusion: In addition to allergic disorders in parents, maternal weight and weight gain during pregnancy, intrapartum and first 6 months of life antibiotic use, and the presence of pets at home were found to be microbiota-related risk factors in children with CMA. Potential strategies related to microbiota composition may contribute positively to the disease's development and progression.
What is known: • The gut microbiome contributes to the development of cow milk allergy, and disrupted microbiota maturation during the first year of life appears to be common in pediatric food allergies. • Factors that influence an infant's microbiota within the first 1000 days and the relationship between these factors and microbiota may enhance allergy diagnosis, prevention, and treatment.
What is new: • Besides parental allergy disorders, maternal weight and weight gain during pregnancy, antibiotic use during intrapartum and first six months of life, and the presence of pets at home were identified as microbiota-related risk factors in children with CMA.
期刊介绍:
The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics.
EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned.
The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics.
EJPE is active on social media (@EurJPediatrics) and we invite you to participate.
EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.