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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 144-149. doi: 10.19723/j.issn.1671-167X.2024.01.022

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Association of pregnancy factors with cow's milk protein allergy in infants

Yangyang LI,Lin HOU,Zijun MA,Shanyamei HUANG,Jie LIU*(),Chaomei ZENG,Jiong QIN   

  1. Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
  • Received:2022-10-31 Online:2024-02-18 Published:2024-02-06
  • Contact: Jie LIU E-mail:yy.lovej@163.com
  • Supported by:
    the 2018 Beijing Key Clinical Specialty Construction Project-Pediatrics(2199000726)

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Abstract:

Objective: To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants. Methods: This study was based on data from a subcohort of a study called genetic susceptibility to cow's milk allergy in Chinese children, including infants born in Peking University People's Hospital between March 1, 2020, and December 31, 2020. The infants were divided into a cow's milk protein allergy (CMPA) group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year. We retrospectively collected the clinical data of infants and their mothers before and during pregnancy, and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants. Results: A total of 278 infants were enrolled in this study, including 52 infants with CMPA and 226 infants without CMPA. Among them, there were 143 boys and 135 girls. The proportion of male infants in the CMPA group (69.2%) was higher than that in the control group (47.3%), and the difference was statistically significant (P=0.004). There were no significant differences in the distribution of birth weight, gestational age at birth, low-birth-weight infants, premature, umbilical cord entangle neck, and neonatal asphyxia between the CMPA group and the control group (P>0.05). The proportion of mothers complicated with autoimmune diseases, anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group, and there were statistical differences between the two groups (P < 0.05). There was no significant difference in the distribution of other pregnancy complications between the two groups (P>0.05), such as eclampsia/preeclampsia, chronic hypertension/gestational hypertension, diabetes/gestational diabetes, thyroid diseases, and so on. There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group (P>0.05). Multivariate Logistic regression analysis showed that male infant, mothers complicated with autoimmune diseases or anemia, antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy. Conclusion: Male infant, mothers complicated with autoimmune diseases or anemia, antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

Key words: Cow's milk protein allergy, Risk factors, Infant, Pregnancy

CLC Number: 

  • R723.1

Table 1

Basic information of participants"

Items CMPA group (n=52) Control group (n=226) χ2/t/Z value P value
Gender, n(%)
    Male 36 (69.2) 107 (47.3) 8.106 0.004
    Female 16 (30.8) 119 (52.7)
Birth weight/g, $\bar x \pm s$ 3 113.4±675.0 3 153.1±533.5 0.46 0.646
Birth weight/g, $\bar x \pm s$ 3 113.4±675.0 3 153.1±533.5 0.460 0.646
Low-birth-weight infant, n(%) 9 (17.3) 25 (11.1) 1.536 0.215
Gestational age/weeks, M(P25, P75) 38.9 (37.7, 39.7) 39.1 (37.9, 40.1) 1.366 0.172
Premature, n(%) 12 (23.1) 42 (18.6) 0.545 0.460
Umbilical cord entangle neck, n(%) 1 (1.9) 8 (3.5) 0.025 0.873
Neonatal asphyxia, n(%) 2 (3.8) 4 (1.8) 0.160 0.689

Table 2

Association of maternal prepregnancy factors with CMPA in offsprings"

Maternal factors CMPA group (n=52) Control group (n=226) χ2/t value P value
Age/years, $\bar x \pm s$ 33.0±4.1 32.7±4.2 0.446 0.656
Ethnic groups, n(%)
    Han 44 (84.6) 205 (90.7) 1.679 0.195
    Other ethnic groups 8 (15.4) 21 (9.3)
Prepregnancy BMI/(kg/m2), n(%)
     < 18.5 3 (5.8) 28 (12.4) 6.049 0.109
    18.5-24.9 42 (80.8) 153 (67.7)
    25.0-29.9 3 (5.8) 34 (15.0)
    ≥30 4 (7.7) 11 (4.9)
Previous pregnancy, n(%)
    None 33 (63.5) 117 (51.8) 2.326 0.127
    ≥1 19 (36.5) 109 (48.2)
Paritya, n(%)
    None 40 (76.9) 149 (65.9) 2.348 0.125
    ≥1 12 (23.1) 77 (34.1)
Histories of abnormal pregnancy and delivery, n(%)
    No 51 (98.1) 212 (93.8) 0.790 0.374
    Yes 1 (1.9) 14 (6.2)

Table 3

Association of maternal pregnancy factors with CMPA in offsprings[n(%)]"

Maternal factors CMPA group (n=52) Control group (n=226) χ2 value P value
IVF-ET a 8 (15.4) 30 (13.3) 0.160 0.690
Cesarean delivery 14 (26.9) 84 (37.2) 1.944 0.163
Hospitalization frequency b
    1 39 (75.0) 181 (80.1) 0.663 0.416
    ≥2 13 (25.0) 45 (19.9)
Eclampsia/preeclampsia 2 (3.8) 19 (8.4) 0.691 0.406
Chronic hypertension/gestational hypertension 9 (17.3) 22 (9.7) 2.447 0.118
Diabetes/gestational diabetes 8 (15.4) 35 (15.5) 0.000 0.985
Thyroid disease 7 (13.5) 36 (15.9) 0.197 0.657
Oligohydramnios 4 (7.7) 22 (9.7) 0.037 0.848
Autoimmune disease 9 (17.3) 18 (8.0) 4.208 0.040
Hypoproteinemia 1 (1.9) 9 (4.0) 0.094 0.760
Anemia 26 (50.0) 65 (28.8) 8.660 0.003
Antibiotics during pregnancy 12 (23.1) 25 (11.1) 5.289 0.021

Table 4

Association of maternal blood routine indicators during pregnancy with CMPA in offsprings"

Maternal factors CMPA group (n=52) Control group (n=224) t/Z value P value
WBC/(×109/L), $\bar x \pm s$ 9.2±2.1 9.1±1.8 0.267 0.789
NE/(×109/L), $\bar x \pm s$ 6.8±1.8 6.7±1.5 0.460 0.646
NE/%, $\bar x \pm s$ 72.5±6.0 72.2±4.8 0.386 0.700
LY/(×109/L), $\bar x \pm s$ 1.8±0.4 1.8±0.4 0.490 0.625
LY/%, $\bar x \pm s$ 19.9±5.3 20.1±4.3 0.359 0.720
NLR, $\bar x \pm s$ 4.2±1.3 4.0±1.2 0.952 0.342
MO/(×109/L), $\bar x \pm s$ 0.57±0.13 0.58±0.14 0.367 0.714
MO/%, $\bar x \pm s$ 6.4±1.3 6.4±1.3 0.230 0.818
LMR, $\bar x \pm s$ 3.2±0.9 3.3±0.9 0.381 0.703
PLR, $\bar x \pm s$ 130.4±44.4 124.6±34.6 1.021 0.308
EO/(×109/L), M(P25, P75) 0.07 (0.03, 0.12) 0.07 (0.05, 0.11) 0.682 0.495
EO/%, M(P25, P75) 0.83 (0.48, 1.19) 0.78 (0.55, 1.19) 0.201 0.841
BA/(×109/L), $\bar x \pm s$ 0.03±0.02 0.03±0.01 0.411 0.682
BA/%, $\bar x \pm s$ 0.35±0.13 0.39±0.11 0.133 0.894

Table 5

Multivariate analysis of risk factors for CMPA"

Risk factors B SE Wald χ2 P OR 95%CI
Malea 0.972 0.343 8.011 0.005 2.643 1.348-5.179
Autoimmune diseaseb 1.109 0.475 5.442 0.020 3.031 1.194-7.693
Anemiab 0.899 0.326 7.599 0.006 2.458 1.297-4.657
Antibiotics during pregnancy 0.868 0.416 4.349 0.037 2.383 1.054-5.388
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