Cord blood IgE: its determinants and prediction of development of asthma and other allergic disorders at 12 months

Background: The value of cord blood IgE in predicting the development of as thma and other IgE-mediated allergic diseases is unclear. Objective: The purpose of this study is twofold: (1) to determine factors a ffecting cord blood IgE level and (2) to determine whether cord blood IgE p redicts the development of asthma and other IgE-mediated allergic diseases in high risk (defined as those with at least one first degree relative with asthma or 2 first degree relatives with other IgE-mediated allergic diseas es) infants at 12 months. Methods: The study utilized cord blood obtained from a group of high risk i nfants who took part in a randomized controlled trial to assess the effecti veness of an intervention program in the primary prevention of asthma and o ther IgE-mediated allergic diseases. Total IgE and cotinine in the cord blo od were measured. Assessment of the infants was done at 12 months for these diseases. Results: Sixty-four (17.8%) infants had detectable total IgE in cord blood >0.5 kU/L. The proportion of infants with elevated cord blood IgE was signi ficantly higher among nonwhites, birth during winter months, and those with a maternal history of asthma. There was no correlation between cord blood IgE and cord blood cotinine level. Cord blood IgE was found to be a signifi cant predictor for the development of urticaria due to food allergy but not for other outcomes. Conclusion: Both genetic and environmental risk factors play a role in dete rmining the level of IgE in cord blood. Cord blood IgE was a significant ri sk factor for the development of urticaria due to food allergy at 12 months of life. As urticaria due to food allergy is a prodrome for anaphylaxis, m easurement of IgE in cord blood may be indicated in infants at high risk fo r developing allergic diseases so that preventive measures can be applied.