Association of Cow's Milk Protein Allergy Prevalence With Socioeconomic Status in a Cohort of Chilean Infants

Abstract

Objectives: The aim of the study was to compare the cow's milk protein allergy (CMPA) prevalence in 2 cohorts of children from different socioeconomic strata. Methods: Prospective birth cohort that included patients from 2 hospitals providing care for a low- and high-income population, respectively. Healthy newborns ≥34 gestational weeks were recruited and followed up to 12 months by a monthly telephone survey. If ≥2 predefined symptoms/signs suggestive of CMPA were detected, the patient was evaluated by a pediatric gastroenterologist. Diagnosis was confirmed by exclusion diet followed by open oral food challenge. Results: Overall the prevalence of CMPA was 5.2%, with a 6 times higher prevalence in the high income cohort (9.2%) compared with the low-income group (1.5%; relative risk 6.2; 95% confidence interval 1.8–20.7; P = 0.0005). All the cases were non-immunoglobulin E–mediated with predominantly gastrointestinal symptoms. High-income cohort did have higher frequency of C-section, mother's previous chronic disease, mother's history of atopy/food allergy, older age, and higher educational level of parents. Parent smoking and presence of pets at home were more frequent in the low-income cohort. Multiple logistic regression showed that the high-income cohort did have older age and higher educational level of both parents. Conclusion: In these cohorts the prevalence of CMPA was higher than reported previously in other developing countries and significantly higher in the high-income group. Our findings were associated with sociodemographic characteristics of the parents.

Clinical characteristics, laboratory findings, and tolerance acquisition in infants with cow's milk protein allergy in a private center in Lima, Peru for the period 2021–2022

“…This clinical profile is similar to other South American regions, as reported by Errazuriz et al, highlighting a predominantly male population with familial atopy history and a similar diet distribution, albeit with a healthier status in their cohort 12 . Similar observations were made in a prospective study conducted in a private center in Chile 13 . However, in regions such as France, Kalach et al reported similar clinical patterns but with a lower proportion of exclusive breastfeeding at diagnosis (33%, less than that in our study) 14 .…”

“…12 Similar observations were made in a prospective study conducted in a private center in Chile. 13 However, in regions such as France, Kalach et al reported similar clinical patterns but with a lower proportion of exclusive breastfeeding at diagnosis (33%, less than that in our study). 14 Exclusive breastfeeding, slightly more prevalent in our CMPA patients' diagnosis (51.66% vs. 48.44%), has been shown to exert a protective effect against CMPA development compared with early infant formula use, as evidenced by a systematic review.…”

“…Studies in Latin America reporting IgE‐mediated versus non‐IgE‐mediated CMPA frequency display variability. Arancibia et al reported exclusively non‐IgE‐CMPA cases in their cohort (20 patients) using food challenges, 13 whereas Mehaudy et al documented a 27.6% frequency of IgE‐mediated CMPA in Argentina 20 . Discrepancies may stem from differences in age at diagnosis, diagnosing specialists, patient demographics, and socioeconomic status.…”

“…Errazuriz et al conducted DBPCFC in 14% of their patients, 12 whereas Arancibia et al performed it in all their patients, albeit employing open oral challenges. 13 Goncalves et al conducted singleblinded oral challenges in Brazil. 21 In our study, DBPCFC was performed in 91% of patients and in all suspected non-IgE-mediated CMPA cases, yielding an 86% positivity rate.…”

Prevalence and Influencing Factors of Food Allergy in Global Context: A Meta-Analysis

“…Mehaudy et al [71], conducting prevalence of cow's milk protein allergy among children in Argentina, has found a percent increase of 0.4% in 2004 to 1.2% in 2014 in the number of cases per year. Arancibia et al [87] found the overall prevalence of cow's milk protein allergy was 5.2%, with a 6 times higher prevalence in the high-income cohort (9.2%) compared with the low-income group (1.5%) in Chilean. Our study demonstrated that the prevalence of FA was 7.5% in Oceania, mainly conducted in Australia.…”