Perinatal probiotic intervention prevented allergic disease in a Caesarean‐delivered subgroup at 13‐year follow‐up

Abstract

Background

The long‐term effects of probiotic intervention for primary prevention of allergic diseases are not well known. We previously reported less eczema until 10 years in our probiotic intervention trial.

Objective

To investigate the effect of early probiotic intervention on the prevalence of allergic diseases up to 13 years of age.

Methods

Pregnant women (n=1223) carrying a child at a high risk of allergy (at least one parent with allergic disease) were randomised to receive a mixture of probiotics (Lactobacillus rhamnosus GG and LC705, Bifidobacterium breve Bb99 and Propionibacterium freudenreichii) or placebo in a double‐blind manner from 36 weeks of gestation until birth. Their infants received the same product for the first six months (registration number NCT00298337). At 13‐year follow‐up the participants were requested to return a questionnaire and to provide a blood sample.

Results

A questionnaire was returned by 642 participants (63.1% of intention‐to‐treat infants) and 459 provided a blood sample. In the whole cohort there were no statistically significant differences in doctor‐diagnosed allergic disease (55.2% and 59.0%, probiotic and placebo group, respectively) or allergic disease (47.9% and 51.6%) based on the ISAAC questionnaire data. Inhalant‐specific IgE‐sensitisation (>0.7 kU/L) was 59.3% in the probiotic group and 49.8% in the placebo group (p=0.040). In a post hoc analysis made in Caesarean‐delivered subgroup allergy was reported in 41.5% of the probiotic group and 67.9% of the placebo group (p=0.006), and eczema in 18.9% and 37.5% respectively (p=0.031). In the whole cohort 8.5% of the probiotic group had suffered from wheezing attacks during the previous 12 months vs. 14.7% in the placebo group (p=0.013). There was no statistically significant differences discovered between the characteristics of the participating group and the dropout‐group.

Conclusions

Probiotic intervention protected Caesarean‐delivered subgroup from allergic disease and eczema, but not the total cohort.

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