Factors influencing adherence in a trial of early introduction of allergenic food

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:144

Article

Perkin, Michael R.¹  Bahnson, Henry T.²  Logan, Kirsty³  Marrs, Tom³  Radulovic, Suzana³  Knibb, Rebecca⁴  Craven, Joanna³  Flohr, Carsten⁵  Mills, E. N.^6,7  Versteeg, Serge A.^8,9  van Ree, Ronald^8,9  Lack, Gideon³ 

[1] St Georges Univ London, Populat Hlth Res Inst, London, England

[2] Benaroya Res Inst, Seattle, WA USA

[3] Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, Paediat Allergy Res Grp, London, England

[4] Aston Univ, Dept Psychol, Birmingham, W Midlands, England

[5] Kings Coll London, Fac Life Sci & Med, Unit Populat Based Dermatol Res, Sch Basic & Med Biosci,St Johns Inst Dermatol, London, England

[6] Univ Manchester, Manchester Acad Hlth Sci Ctr, Div Infect Immun & Resp Med, Sch Biol Sci, Manchester, Lancs, England

[7] Univ Manchester, Manchester Inst Biotechnol, Manchester, Lancs, England

[8] Acad Med Ctr, Dept Expt Immunol, Amsterdam, Netherlands

[9] Acad Med Ctr, Dept Otorhinolaryngol, Amsterdam, Netherlands

关键词: Food allergy;    diet;    allergens;    infancy;    breastfeeding;    randomized controlled trial;    adherence;   

DOI  :  10.1016/j.jaci.2019.06.046

来源: Elsevier

【 摘 要 】

Background: The Enquiring About Tolerance (EAT) study examined whether the early introduction of 6 allergenic foods from 3 months of age in exclusively breastfed infants prevented the development of food allergy. The intervention was effective in the per-protocol analysis for allergy to 1 or more foods and for egg and peanut individually, but only 42% of early introduction group (EIG) children met the per-protocol criteria. Objective: We sought to identify which factors were responsible for nonadherence in the EAT study. Methods: Factors influencing adherence within the key early introduction period in the EIG (up to 6 months of age) were divided into enrollment and postenrollment factors, and their association with nonadherence was explored. Results: In an adjusted analysis, at enrollment, increased maternal age, nonwhite ethnicity, and lower maternal quality of life were independently and significantly associated with overall nonadherence in the EIG. Enrollment eczema and enrollment serum allergen-specific IgE sensitization to 1 or more foods (>= 0.1 kU/L) were not related to overall nonadherence. After enrollment, 2 factors were significantly related to EIG overall nonadherence: parent-reported IgE-type symptoms with infant allergenic food consumption by 6 months of age and reported feeding difficulties by 4 months of age. Conclusion: If early introduction of allergenic foods were to be considered a strategy to prevent food allergy, families of nonwhite ethnicity, those with older mothers, and those with infants with reported feeding difficulties or early-onset eczema would benefit from support to promote early and sustained consumption.

【 授权许可】

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