一项关于富含鸡蛋和花生的母亲饮食以减少婴儿过敏的试验。
完整摘要 · 中文译文
背景：导致食物过敏的免疫反应可能在生命早期形成，甚至可能在引入固体食物之前就已出现。通过子宫内和母乳接触食物过敏原已被提议作为预防婴儿食物过敏的策略，但缺乏来自随机试验的证据。 方法：在这项多中心、随机试验中，孕妇的未出生子女至少有两名生物学家庭成员经医学诊断患有过敏性疾病，则有资格参加。参与者按1：1的比例被分配，从妊娠23周之前直到产后哺乳期4个月，遵循高鸡蛋和花生饮食（每周至少摄入6个鸡蛋和60颗花生）（高鸡蛋-花生组）或标准（对照）鸡蛋和花生饮食（每周摄入不超过3个鸡蛋和30颗花生）（标准饮食组）。主要结局是婴儿1岁时发生IgE介导的鸡蛋或花生过敏。 结果：共有1070名参与者被分配到高鸡蛋-花生组，1067名被分配到标准饮食组。母体高鸡蛋-花生组婴儿发生IgE介导的鸡蛋或花生过敏的百分比（1066人中的83人，7.8%）与标准饮食组（1064人中的89人，8.4%）之间没有显著差异（相对风险，0.93；95%置信区间，0.69至1.26；P=0.65）。两组的各项安全指标相似。 结论：与摄入少量这些食物相比，在妊娠期和哺乳期摄入大量鸡蛋和花生，并未导致婴儿至1岁时发生鸡蛋或花生过敏的风险显著降低。（由澳大利亚国家健康与医学研究委员会及其他机构资助；PrEggNut澳大利亚新西兰临床试验注册号，ACTRN12618000937213。）
完整摘要 · 英文原文
BACKGROUND: Immune responses leading to food allergy may develop early in life, potentially before the introduction of solid foods. Exposures to food allergens in utero and through breast milk have been proposed as a strategy to prevent food allergies in infants, but evidence from randomized trials is lacking. METHODS: In this multisite, randomized trial, pregnant women whose unborn child had at least two biologic family members with medically diagnosed allergic disease were eligible to participate. Participants were assigned in a 1:1 ratio to follow either a diet high in eggs and peanuts that included at least 6 eggs and 60 peanuts per week (high egg-peanut group) or a standard (control) egg and peanut diet that included no more than 3 eggs and 30 peanuts per week (standard-diet group), from before 23 weeks' gestation until 4 months postnatally during lactation. The primary outcome was IgE-mediated egg or peanut allergy in the infant at 1 year of age. RESULTS: A total of 1070 participants were assigned to the high egg-peanut group, and 1067 were assigned to the standard-diet group. There was no significant difference in the percentage of infants with IgE-mediated egg or peanut allergy between the maternal high egg-peanut group (83 of 1066, 7.8%) and the standard-diet group (89 of 1064, 8.4%) (relative risk, 0.93; 95% confidence interval, 0.69 to 1.26; P = 0.65). Safety measures were similar in the two groups. CONCLUSIONS: The ingestion of high amounts of egg and peanut during pregnancy and lactation did not result in a significantly lower risk of the development of egg or peanut allergy in infants by 1 year of age than ingestion of low amounts of these foods. (Funded by the Australian National Health and Medical Research Council and others; PrEggNut Australian New Zealand Clinical Trial Registry number, ACTRN12618000937213.).