Significance of IgE level in amniotic fluid and cord blood for the prediction of allergy.

Intrauterine sensitization has been reported in animal and clinical studies. One study suggests that the amniotic fluid (AF) IgE level might be useful in predicting infant allergy. We followed for 1 year 83 newborns on whom we had 78 samples of AF, 82 of cord serum (CS), and 83 of maternal serum (MS). All infants were delivered by C-section at term. Amniotic fluid samples were aspirated through the exposed myometrium. Sanguineous specimens were excluded. Amniotic fluid, CS, and MS were tested for total IgE level and IgE RAST to three foods: cow's milk, egg white, and peanut. Data on family medical history, feeding history, and allergy symptoms were collected for 12 months. By 1 year 23% had probable allergy: recurrent wheezing = 8, food related G.I. symptoms = 7, and atopic dermatitis = 4. Allergy in formula-fed infants occurred more often than in those breast-fed for greater than 6 months. IgE in AF was greater than or equal to 0.5 IU/mL in 21/78 (27%); range = 0.5 to 5.9 and geometric mean = 0.76. No correlation was noted between AF total IgE and the appearance of allergy. RAST was equivocally positive in 1.2% AF. Cord serum total IgE was greater than or equal to 0.5 IU/mL in 6/82 (7%); range = 0.5 to 2.6 and geometric mean = 0.72. Allergy appeared in 67% of infants with CS total IgE greater than or equal to 0.5 IU/mL. RAST was negative in all CS samples. In this limited series, AF IgE did not seem to have predictive value of allergy in infancy.