Prenatal Air Pollution and Childhood Allergic Diseases: The Potential Modifying Effect of Adherence to Mediterranean Diet

摘要

Background: Prenatal exposure to air pollution has been associated with increased risk of childhood asthma and allergies, however, less is known regarding the potential modifying effect of maternal diet during pregnancy in this association. Objectives: To investigate whether prenatal exposure to particulate matter (PM) is associated with childhood eczema, allergic rhinitis (AR) and asthma, and to assess a potential modifying effect by maternal adherence to Mediterranean Diet (MD) using data from the Rhea pregnancy cohort. Methods: Allergic outcomes were evaluated in children at ages 4 (n=809) and 6 (n=567) years old using validated questionnaires. Land-use regression models and back-extrapolation procedures were utilized to estimate outdoor levels of PM2.5, PM10, and PMcoarse at home addresses during pregnancy. MD was assessed by a validated food frequency questionnaire, and MD adherence was evaluated using an a priori score. Multivariate logistic regression models were used and interaction terms with MD were added in the model to evaluate any PM by MD effect modification. Results: Overall, prenatal PM exposure was significantly associated with an increased risk of AR and eczema at ages 4 and 6 but not with asthma. Stratified analysis by MD adherence indicated that PM2.5 exposure was associated with an increased risk of AR and eczema at age 4 (OR, 95%CI: 2.74, 1.47-5.12 and 2.01,1.02-3.93, respectively) in children of mothers with low MD adherence, whereas this effect was not apparent in children of mothers with high MD adherence (Pinteraction 0.027 and 0.017, respectively). Similarly, PMcoarse exposure was associated with an increased risk of eczema at both 4 and 6 years old (Pinteraction 0.015 and 0.043, respectively), and PM10 with eczema at 6 years old only in children of mothers with low MD adherence (Pinteraction 0.033). Conclusion: Maternal adherence to MD may modify the detrimental effect of prenatal air pollution on childhood allergy.