38591
document
Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort . BACKGROUND Less microbial exposure in early childhood is associated with more allergic disease later . Allergic children have a different fecal microflora , with less lactobacilli and bifidobacteria . Beneficial effects regarding the development of allergy have been suggested to come through probiotic supplementation . OBJECTIVE We sought to study the effect of probiotic and prebiotic supplementation in preventing allergies . METHODS In a double-blinded , placebo-controlled study we randomized 1223 mothers with infants at high risk for allergy to receive a probiotic mixture ( 2 lactobacilli , bifidobacteria , and propionibacteria ) or placebo during the last month of pregnancy and their infants to receive it from birth until age 6 months . Infants also received a prebiotic galacto-oligosaccharide or placebo . At 5 years , we evaluated the cumulative incidence of allergic diseases ( eczema , food allergy , allergic rhinitis , and asthma ) and IgE sensitization . RESULTS Of the 1018 intent-to-treat infants , 891 ( 88 % ) attended the 5-year visit . Frequencies of allergic and IgE-associated allergic disease and sensitization in the probiotic and placebo groups were similar : 52.6 % versus 54.9 % and 29.5 % versus 26.6 % , respectively , and 41.3 % in both . No significant difference appeared in frequencies of eczema ( 39.3 % vs 43.3 % ) , atopic eczema ( 24.0 % vs 25.1 % ) , allergic rhinitis ( 20.7 % vs 19.1 % ) , or asthma ( 13.0 % vs 14.1 % ) between groups . However , less IgE-associated allergic disease occurred in cesarean-delivered children receiving probiotics ( 24.3 % vs 40.5 % ; odds ratio , 0.47 ; 95 % CI , 0.23 % to 0.96 % ; P = .035 ) . CONCLUSIONS No allergy-preventive effect that extended to age 5 years was achieved with perinatal supplementation of probiotic bacteria to high-risk mothers and children . It conferred protection only to cesarean-delivered children .
38592
Intervention_Pharmacological
Probiotics
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Intervention_Pharmacological
probiotic and prebiotic supplementation
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Intervention_Control
placebo-controlled
38595
Intervention_Pharmacological
probiotic mixture ( 2 lactobacilli , bifidobacteria , and propionibacteria )
38596
Intervention_Control
placebo
38597
Intervention_Pharmacological
prebiotic galacto-oligosaccharide
38598
Intervention_Control
placebo
38599
Intervention_Pharmacological
probiotic
38600
Intervention_Control
placebo
38601
Intervention_Pharmacological
probiotics
38602
Intervention_Pharmacological
probiotic bacteria
38603
Outcome_Physical
allergic diseases ( eczema , food allergy , allergic rhinitis , and asthma )
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Outcome_Physical
IgE sensitization
38605
Outcome_Physical
Frequencies of allergic and IgE-associated allergic disease
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Outcome_Physical
sensitization
38607
Outcome_Physical
frequencies of eczema
38608
Outcome_Physical
atopic eczema
38609
Outcome_Physical
allergic rhinitis
38610
Outcome_Physical
asthma
38611
Outcome_Physical
IgE-associated allergic disease
38612
Participant_Condition
in cesarean-delivered
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Participant_Age
children
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Participant_Condition
Allergic
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Participant_Sample-size
1223 mothers
38616
Participant_Age
infants
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Participant_Condition
high risk for allergy
38618
Participant_Age
infants
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Participant_Age
age 6 months
38620
Participant_Sample-size
1018 intent-to-treat
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Participant_Sample-size
891 ( 88 % ) attended
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Participant_Condition
high-risk