10 Centers for Disease Control. Classification system for httman T-lymphotropic virus type III/lvmphadenopathy-associated virus infections. MMWR

Abstract. One hundred and twenty‐one women with history of a previous child with atopic disease were randomly allocated during the next pregnancy to antigen avoidance or control groups. Dietary advice consisted of almost complete exclusion of milk and dairy products, egg, fish, beef and peanut throughout pregnancy and lactation. A total of 109 completed the study. Maternal antigen avoidance was associated with reduced occurrence of atopic eczema and the skin involvement was less extensive and milder. The beneficial effect was observed mainly in the breast‐fed group. Among the fifty‐five who completed the trial of antigen avoidance, seventeen infants developed atopic eczema, five out of thirty‐five who were breast‐fed and twelve out of twenty who were formula‐fed. Among the offspring of fifty‐four control mothers given no dietary restriction, eczema was observed in twenty‐four infants, eleven out of thirty‐six breast‐fed and thirteen of eighteen formula‐fed. Avoidance of common dietary allergens during pregnancy and lactation enhanced the preventive beneficial effect of exclusive breast feeding on the incidence of atopic eczema among infants at high risk.

Summary The predictive value of cord blood IgE in the development of atopic disease was evaluated in a prospective study of two groups of infants. Total serum IgE level was ≥ 0.7 U/ml in 44.3% of the infants with positive family history of atopy and in 16.0% among those with negative family history. The level of cord blood IgE correlated significantly with the subsequent development of atopic disease in both groups. Cord blood IgE higher than 0.7 U/ml was associated with a high risk of development of atopic eczema and wheezing, 52.8% and 58.8% respectively in the groups with or without family history of atopy; compared with 13.4% and 1.1% in the groups with IgE levels less than 0.7 U/ml. Among newborns fed exclusively on breast milk for a minimum of 3 months, the incidence of eczema and wheezing was significantly lower (12%) compared with findings in the formula‐fed group (32%).