J ALLERGY CLIN IMMUNOL

FEBRUARY 2014

AB206 Abstracts

MONDAY

712 Prenatal and Postnatal Factors Associated With IgE-Mediated Wheat Allergy In Infants: A Study In AsianPopulation

Dr. Suparat Sirivimonpan, MD; Chulalongkorn University, Bangkok,

Thailand.

RATIONALE: Wheat allergy is a growing problem in Asian countries.

Factors associated the diseases from western studies may not apply to the

population because of genetic, geographical and dietary differences. Early

life circumstances may affect development of sensitization and food

allergy. We aimed to determine prenatal and postnatal factors associated

with wheat allergy.

METHODS: Using case-control design, 47 infants with IgE-mediated

wheat allergy and 188 gender and age matched controls were enrolled.

Personal histories and associated factors were analysed.

RESULTS: Ninety-two percent of wheat-allergic infants had symptoms

on first exposure, suggested the role of sensitization intrauterine or via

breast milk. Anaphylaxis occurred in 19% of subjects. Parental atopic

histories and high socioeconomic status significantly increased the risk of

wheat allergy. IgE-mediated wheat allergy was independently associated

with maternal wheat consumption during pregnancy (bread>3 pieces per

week, adjusted odds ratio, 3.7; 95% confidence interval, 1.8 to

7.5;P50.001), and breast feeding beyond 6 months (adjusted odds ratio,

2.3; 95 % confidence interval, 1.1 to 4.8;P50.03). Delayed wheat

introduction after 6 months of age had trend toward the association with

IgE positivity to wheat (adjusted odds ratio 1.8; 95 % confidence interval,

0.9 to 3.9;P50.09).

CONCLUSIONS: Several factors during prenatal and early life period

associated with the risk of IgE-mediated wheat allergy. Our findings

demonstrated that genetic predisposition and socioeconomic status

strongly increased risk of wheat allergy. Maternal consumption of wheat

during pregnancy and prolonged breast feeding were significantly

associated with the disease. Developing the strategies to prevent wheat

allergy requires consideration of all these factors.

713 Maternal Healthy Diet and Development Of Allergic DiseaseDr. Carina Venter, PhD, RD1, Ms. Harriet R. Moonesinghe2,

Prof. Hasan Arshad3,4, Prof. Taraneh Dean2,5, Mrs. Jane Grundy3,

Mrs. Gill Glasbey3, Dr. Veeresh Patil3,4; 1The David Hide Asthma and Al-

lergy Research Center, Isle of Wight, United Kingdom, 2University of

Portsmouth, School of Health Sci, Portsmouth, United Kingdom, 3The

David Hide Asthma and Allergy Centre, Newport, United Kingdom, 4Uni-

versity of Southampton, Southampton, United Kingdom, 5The David Hide

Asthma and Allergy Centre, Newport.

RATIONALE: Maternal healthy diet may play a role in the development

of allergic diseases and need further investigation.

METHODS: Pregnant women (n5 969) were recruited at 12 weeks

gestation; a FFQ was completed at 36 weeks. Reported symptoms of

allergic disease were obtained during infants first three years, and at 10

years. Children were skin prick tested to a panel of food and aero-allergens

and food challenges conducted. Healthy Eating Index (HEI) was calculated

as: multivitamin/mineral intake (2) + folic acid (1) + omega-3 fatty acids

(1) + regular white fish(1)/ fatty fish intake (2) +citrus fruit (1) + >_ 5/day

fruit and vegetables (2) 5 10

RESULTS: Maternal diets scored low on HEI: 949/969 (97.9%) scored

0-5 and 20/969 (2.1%) scored 6-10. Using this binary HEI factors, no

association with atopy (+ SPT) (3 years; p50.589 and 10 years; p5 0.519),

reported allergic diseases (3 years; p50.489 and 10 years; p50.636) and

food allergy (FA) (3 years; p50.450 and 10 years; p50.365) was seen. HEI

as continuous variable was associated with FA by 3 years (p5 0.010; OR

1.244 [95% CI: 1.055 – 1.468]) even after adjusting for maternal allergic

history and smoking, pet exposure and sibship. FA at 10 years showed no

association (p50.128, OR 0.723 [0.475 – 1.099]). Fatty fish intake was

associated with increased risk of atopy by 3 years (p50.023).

CONCLUSIONS: The role of healthy diet on development of allergic

disease need more investigation using a robust method measuring food

intake and sufficient numbers of healthy eating mothers.

714 Effect Of Annual Income On Parental/Family Burden Of FoodAllergy

Dr. David A. Petty, DO1, Jay A. Lieberman, MD2, Nhu Quynh Tran,

PhD3; 1University of Tennessee Allergy fellowship program, Memphis,

TN, 2University of Tennessee, Memphis, TN, 3University of Tennessee

Department of Preventative Medicine.

RATIONALE: Having a child with food allergies can cause a significant

burden for families. We hypothesized the effect that a child’s food allergy

would have on the family’s quality of life would be different among

different socio-economic classes.

METHODS: Parents of pediatric patients with physician-diagnosed food

allergies were recruited from both a university and a private allergy clinic.

Participants completed the Food Allergy Quality of Life-Parental Burden

(FAQL-PB) questionnaire. Background and demographic data were also

collected, family incomes were reported in quintiles (<$25,000, $25,000-

50,000, $50,000-75,000, $75,000-100,000, and >$100,000). Wilcoxon

rank sum tests were used for univariate analyses. Multiple linear regression

was used to model the relationship between exploratory variables and the

FAQL-PB scores.

RESULTS: Data from 77 respondents were analyzed. Themean age of the

food-allergic child was 6.69 years (range 1-17). 86% of respondents were

mothers. The majority of respondents were either black (46%) or white

(42%). In the univariate analysis, there was a significant difference in the

FAQL-PB scores among different family income levels (P50.01), with the

lowest scores seen in the $75,000-100,000 income quintile. This signif-

icance held in the multivariable analysis (P50.02). Factors associated with

a decreased quality of life in the univariate analysis included if the

respondent was the child’s mother (P50.03) and if the child was allergic to

milk (P50.01) or wheat (P50.04).

CONCLUSIONS: In this survey study, there was a statistically significant

variance in FAQL-PB scores among different family income levels, with

the least perceived family burden seen in families reporting income levels

between $75,000-100,000.

715 Food Allergy and Anaphylaxis Educational NeedsAssessment, Training Curriculum and Assessment OfKnowledge Of Urban Child Care Center Workers

Dr. Bruce J. Lanser, MD1, Dr. Ronina A. Covar, MD1, David Mark

Fleischer, MD, FAAAAI1, Dr. J. Andrew Bird, MD, FAAAAI2; 1National

Jewish Health, Denver, CO, 2UT Southwestern Medical Center, Dallas, TX.

RATIONALE: More than half of preschool aged children are enrolled in

child care, and nearly 10% between ages 3 and 5 have a food allergy. The

need exists for food allergy and anaphylaxis educational needs assessment

and training curriculum for child care center workers.

METHODS: An online educational needs assessment and live training

curriculum with pre and post-test were created, reviewed by experts and

piloted with a focus group of child care workers to obtain content and face

validity. A SurveyMonkey link to the needs assessment was sent to email

addresses from the state licensing agency to centers in Dallas and Tarrant

Counties. The curriculum and eighteen question test addressed the areas of

understanding labeling and the definition of food allergy, recognizing a

reaction and treatment.

RESULTS: Seventy-three workers responded to the online needs assess-

ment, with 43% having food allergy training. They identified their sources

as parents (73%), self-taught (54%), educational curricula (21%) and

conferences (19%). The majority felt they have a high or moderately high

proficiency in food allergy management. Forty-five workers participated in

the training curriculum, presented at regional child care conferences. Total

scores improved from 54% correct on pre-test to 83% on post-test,

(p<0.0001). Categorical sub-analysis reveals similar results, with statisti-

cally significant improvement in all areas.

CONCLUSIONS: Child care center workers have diverse educational

backgrounds and infrequently experience standardized training about food

allergies. There is a significant lack of knowledge regarding food allergies

and anaphylaxis. The curriculum was successful at educating workers to

more safely care for children with food allergies.