xRead - September 2022

Wise et al.

Page 303

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE VI.C. Evidence for the effects of food allergen exposure (in utero and early childhood exposure) on the development of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Zeiger et al. 573 1995 1b RCT 1 Infants whose mothers avoided cow’s milk, egg, and peanut in the last trimester of pregnancy and lactation and who themselves avoided cow’s milk until age 1 year (casein hydrolysate supplementation before age 1), egg until age 2 years, and peanut and fish until age 3 years; 2 Standard feeding practices. Food allergy, atopic dermatitis, AR, asthma, any atopic disease, lung function, food or aeroallergen sensitization, serum IgE level, presence of nasal eosinophils or basophilic cells at age 7 years. No significant difference between treatment groups, though children with food allergy by 4 years had a higher 7 year prevalence of AR and asthma. Lilja et al. 570 1989 1b RCT Women with respiratory allergy to animal danders and/or pollens in the last 3 months of pregnancy randomized to: 1 Very low ingestion of egg and cow’s milk; 2 Daily ingestion of egg and cow’s milk. Incidence of atopic diseases at 18 months of age No significant difference in the distribution of atopic disease in relation to the maternal diet during late pregnancy. Falth-Magnusson et al. 571 1987 1b RCT 1 Strictly cow’s milk-free and egg-free diet from week 28 to delivery; 2 Normal diet including cow’s milk and egg. Skin prick, serum IgE, atopic manifestations (not AR) Maternal elimination diet during late pregnancy does not protect the baby against atopy. Maternal elimination diet during late pregnancy is associated with low weight gain and preterm birth. Alduraywish et al. 564 2016 2a Meta-analysis Asthma, AR, eczema or sensitization against food allergens Food sensitization in the first 2 years of life can identify children at high risk of subsequent allergic disease, including AR. Zutavern et al. 572 2008 2b Population based, prospective birth cohort study Asthma, AR, eczema or sensitization against food or inhalant allergens No evidence supporting a delayed introduction of solids beyond 4–6 months.

AR = allergic rhinitis; IgE = immunoglobulin E; LOE = level of evidence; RCT = randomized controlled trial.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.