Abstract
Total IgE and specific IgG levels to β-lactoglobulin and ovalbumin and allergy development were investigated in 22 small for gestational age (SGA) infants monitored for 12 months. A high incidence of allergy was observed at 12 months corrected age relative to published reports on appropriate for gestational age infants. This was particularly noticeable in infants from a nonatopic background, where 56% (5/9) were allergic, as well as in infants with a family history of atopy, where 85% (11/13) were diagnosed as allergic at 12 months corrected age. There was a nonsignificant (NS) trend for total serum IgE levels to increase with age in infants from both atopic and nonatopic backgrounds. Levels of β-lactoglobulin IgG peaked at 4 months corrected age in both groups and had decreased by 12 months corrected age, reflecting the induction of tolerance (median and range, 4 months corrected age vs. 12 months corrected age; atopic: 904 (8-3437) μg/ml vs. 449 (53-3200) μg/ml, p < 0.02; nonatopic: 836 (39-1473) μg/ml vs. 503 (85-1914) μg/ml, p = NS). Ovalbumin IgG antibody levels decreased between 40 weeks gestational age and 4 months corrected age (atopic: 66 (9-382) μg/ml vs. 33 (6-599) μg/ml, p = NS; nonatopic: 40 (8-1026) μg/ml vs. 16 (7-62) μg/ml, p < 0.05) before reaching their highest level at 12 months corrected age [atopic: 551 (17-3147) μg/ml, both 40 weeks gestational age and 4 months corrected age vs. 12 months corrected age, p < 0.005; nonatopic: 286 (13-1791) μg/ml, p = NS]. These changes reflect the degradation of maternal IgG in the infant and lack of egg in the early diet, followed by the introduction of egg products during weaning. This finding of a high allergy incidence in SGA infants should be further investigated.
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