Research Article: Antenatal risk factors for peanut allergy in children

Date Published: October 4, 2011

Publisher: BioMed Central

Author(s): Karen E Binkley, Chad Leaver, Joel G Ray.


Prenatal factors may contribute to the development of peanut allergy. We evaluated the risk of childhood peanut allergy in association with pregnancy exposure to Rh immune globulin, folic acid and ingestion of peanut-containing foods.

We conducted a web-based case-control survey using the Anaphylaxis Canada Registry, a pre-existing database of persons with a history of anaphylaxis. A total of 1300 case children with reported peanut allergy were compared to 113 control children with shellfish allergy. All were evaluated for maternal exposure in pregnancy to Rh immune globulin and folic acid tablet supplements, as well as maternal avoidance of dietary peanut intake in pregnancy.

Receipt of Rh immune globulin in pregnancy was not associated with a higher risk of peanut allergy (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.51 to 1.45), nor was initiation of folic acid tablet supplements before or after conception (OR 0.53, 95% CI 0.19 to 1.48). Complete avoidance of peanut-containing products in pregnancy was associated with a non-significantly lower risk of peanut allergy (OR 0.53, 95% CI 0.27 to 1.03).

The risk of childhood peanut allergy was not modified by the following common maternal exposures in pregnancy: Rh immune globulin, folic acid or peanut-containing foods.

Rh immune globulin, folic acid supplement use and peanut avoidance in pregnancy have yet to be proven to modulate the risk of childhood anaphylaxis to peanuts.

Identification of prenatal factors that contribute to peanut allergy might allow for prevention of this life-threatening condition. This article explores the role of three such factors.

Partial Text

Prenatal and early life factors may contribute to the subsequent development of allergic conditions in childhood [1]. A better understanding and prevention of exposure to such factors could theoretically lead to the rational amelioration of some common and potentially life-threatening allergic conditions. In this study, we focused on three potentially important factors in the prenatal period: Rh immune globulin, folic acid supplements and ingestion of peanut-containing foods.

A retrospective web-based case-control study was completed using the Anaphylaxis Canada Registry. This registry is a pre-existing database comprising approximately 8,000 anaphylactic patients registered from across Canada [[10], accessed 2008]. Members of Anaphylaxis Canada form a group of highly motivated individuals who are eager to participate in research on severe allergy in children. Response rates to previous research projects are typically over 85%.

A total of 1300 mothers of cases with peanut allergy and 113 mothers of controls with shellfish allergy completed the current survey.

We evaluated three different antenatal maternal exposure factors in association with childhood peanut allergy. We did not detect an association with either Rh immune globulin or antenatal folic acid tablet supplementation and peanut allergy. Reduced ingestion of peanut products in pregnancy was associated with a non-significantly lower risk, however.

Supported by a grant-in-aid from the Division of Allergy and Clinical Immunology, St. Michael’s Hospital, Toronto, Ontario, Canada

CI: confidence interval; DNA: deoxyribonucleic acid; OR: odds ratio.

The authors declare that they have no competing interests.

KB conceived of the study, participated in study design, and manuscript preparation. CL participated in study design, set up the web-based questionnaire, performed statistical analysis, and participated in manuscript preparation. JR participated in study design, data analysis, and manuscript preparation. All authors have read and approved the final manuscript.