Incidence and Early-Life Risk Factors for Food Allergy in a Spanish Birth Cohort.

AIM: The prevalence of food allergy has increased in recent decades. We aimed to determine the cumulative incidence of food allergy in early childhood and to identify associated risk factors.

METHODS

We conducted a prospective birth cohort study including 1006 newborns recruited over one year at a single hospital in Spain and followed until 4 years of age. Data were collected at birth and through structured telephone interviews during follow-up. Children with suspected food allergy underwent skin prick testing, specific serum IgE measurement and open oral food challenges when indicated.

RESULTS

The cumulative incidence of food allergy was 7.2% (72/1006). Independent risk factors for IgE-mediated food allergy included hospitalization for bronchospasm (adjusted odds ratio [aOR] 2.37; 95% CI 1.07-5.26), atopic dermatitis (aOR 7.52; 95% CI 3.77-15.01), maternal asthma (aOR 3.12; 95% CI 1.30-7.53) and paternal allergic rhinitis (aOR 2.79; 95% CI 1.31-5.94). Proton-pump inhibitor use, absence of daycare attendance and early-onset atopic dermatitis were associated with non-IgE-mediated food allergy.

CONCLUSION

In this Spanish birth cohort, food allergy affected 7.2% of children by age 4. Atopic dermatitis was the main risk factor for IgE-mediated food allergy, while potentially modifiable early-life exposures were associated with non-IgE-mediated forms.