Natural Course and Factors Associated with Allergic Diseases in Early
Life: Data from a Developing Asian Country
Abstract
Background: The incidence of allergic diseases has been rising in the
last decades. The interplay between genetic and environmental factors
underlined these complex diseases. Data concerning natural history and
risk factors associated with allergic diseases in developing Asian
countries are limited. Methods: A population-based birth cohort study
was conducted in Bangkok, Thailand. Perinatal and postnatal factors were
prospectively collected by questionnaires. Sensitization was identified
by skin prick test. Food allergy (FA) was confirmed by oral food
challenge. Results: A total of 369 mother-children pairs were enrolled
and follow-up until the age of 30 months. The cumulative incidence of
allergic diseases was 46.2%. High family income significantly increased
risk of atopic dermatitis (AD) and ever-wheezing. Maternal history of
allergic diseases and exclusive breastfeeding longer than six months
significantly increased risk of FA. Antibiotics use in infants
significantly associated with FA, ever-wheezing and rhinitis. Infants
with FA had a 6.5-fold increased risk of AD while infants with AD had an
8.5-fold increased risk of FA. AR had a 3.5-fold increased risk in
developing ever-wheezing. One-third of the subjects had aeroallergen
sensitization. Conclusion: Prevalence of allergic diseases in developing
Asian country was considerably high. AD and FA were the most prevalent
allergic diseases during the first years of life. Meanwhile, the
prevalence of wheezing and rhinitis subsequently increased over time.
High sensitization rate to aeroallergens was found in the first two
years of life. Maternal atopy, high family income, early life exposure
to antibiotics and prolonged breast-feeding increased risk of allergic
diseases in our cohort.