==== Front Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2006.408asm-5-408LettersInfluence of atopic history on cord blood IgE Kashef Mohammad Amin Kashef Sara Pishva Narjes Afshari Mozhgan Jalaeian Hamed Amirghofran Zahra Correspondence: Sara Kashef, MD, Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Pediatric Office, Namazee Hospital, Zand Avenue, Postal code: 71937 Shiraz, Iran. T: +98 9173161041, F: +98 711 6265024, kashefs@sums.ac.irSep-Oct 2006 26 5 408 410 Copyright © 2006, Annals of Saudi Medicine2006This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. ==== Body To the Editor: An increase in cord blood IgE (CB-IgE) is considered an effective immunologic predictor which can be used to screen neonates for the risk of atopic diseases.1,2 Maternal atopic diseases and family atopic history have been proposed as two important risk factors determining CB-IgE in neonates.1,2,3 To determine the influence of atopic family history on cord blood IgE, a total of 201 cord blood samples were examined for total IgE concentration from 100 newborns with a family history of atopic disorders and 101 newborns with no history of atopic disorders, assigned as a control or low-risk group, from the Obstetric Ward at Hafez Hospital, Shiraz, Iran, from August to December 2002. All were ethnic Iranian families and informed consent was obtained from parents. This study was approved by our university ethics committee. The atopic history of parents was collected in the third trimester by means of a standard questionnaire of asthma, allergic rhinitis, atopic dermatitis, and urticaria based on the ‘International Study of Asthma and Allergies in Childhood’ questionnaire.4 A last year medical student interviewed mothers and filled in the questionnaires. The serum total IgE level of cord blood was determined by enzyme-linked immunosorbent assay (ELISA). A standard calibration curve was constructed. Elevated cord blood IgE values were cut off at the level of 0.5 IU/mL according to the previous reference cut off point.5 All data were processed using the SPSS program. There was no significant difference in mean age of mothers, mean gestational age, and mean birth weight between case and control groups. Fifty-one newborns in the case group and 65 newborns in the control group had values of cord blood IgE higher than 0.5 IU/mL (P=0.158, chi-square) (Figure 1). We found no significant difference for cord blood IgE levels between the case and control groups. Our study demonstrated that a family history of atopy is not a risk factor for elevated CB-IgE. The same result was achieved in a survey conducted in Taiwan, indicating that allergic history of parents does not correlate with elevated CB-IgE levels of neonates.6 However, another study conducted in the same region demonstrated that family history of atopy is a risk factor for elevated CB-IgE.7 In comparing the results of the present study with others one should consider the different methods for determination of IgE and different cut-off points used in the analysis, as well as differences in the population groups examined. Researchers have frequently argued about the bias from questionnaires of allergy history because the questionnaires were answered by mothers, who probably misinterpret the paternal allergic history.8 Certain studies have shown that a maternal history of atopy, but not paternal history correlates with the elevated CB-IgE levels, suggesting that maternal and/or placental factors can significantly affect prenatal IgE synthesis.1,9 In a study conducted in Germany the influence of atopic family history on CB-IgE proved to be strong and the percentage of elevated IgE values increased significantly with the number of atopic family members.3 Kaan et al found that a maternal history of asthma was the most important determinant for high CB-IgE,2 and Magnusson reported that infants with a positive immediate family history had a higher incidence of elevated cord IgE.1 We tried to define clear criteria so as to eliminate questionnaire bias. To avoid contamination at sampling cord blood was collected using direct needle aspiration of the cord vein.10 Also, acceptable techniques were used in detecting CB-IgE levels and therefore existing variations in results with some other reports should be a matter of ethnic variations. In conclusion, the influence of atopic history on cord blood IgE levels was not confirmed in this study. Figure 1 Distribution of cord blood IgE according to family atopic history. ==== Refs References 1 Magunsson CG Cord serum IgE in relation to family history and as predictor of atopic diseases in early infancy Allergy 1988 43 241 251 3389491 2 Kaan A Dimich-Ward H Manfreda J Becker A Watson W Ferguson A Cord blood IgE: its determinants and prediction of asthma and other allergic disorders at 12 months Ann Allergy Asthma Immunol 2000 84 37 42 10674563 3 Bergmann RL Schulz J Gunther S Dudenhausen JW Bergmann KE Bauer CP Determinants of cord blood IgE concentrations in 6401 German neonates Allergy 1995 50 65 71 7741190 4 Asher MI Keil U Anderson HR Beasley R Crane J Martinez F International study of asthma and allergies in childhood (ISAAC): rational and methods Eur Respir J 1995 8 483 491 7789502 5 Ownby DR Clinical significance of immunoglobulin E Adkinson NF Yunginger JW Busse WW Bochner BS Holgate ST Simons FER Middleton’s allergy principles and practice Pennsylvania Mosby 2003 1087 1103 6 Liu CA Wang CL Chuang H Ou CY Hsu TY Yang KD Prediction of elevated cord blood IgE levels by maternal IgE levels, and the neonate’s gender and gestational age Chang Gung Med J 2003 26 561 9 14609036 7 Lin YC Wen HJ Lee YL Guo YL Are maternal psychosocial factors associated with cord immunoglobulin E in addition to family history and mother immunoglobulin E? Clin Exp Allergy 2004 34 548 554 15080806 8 Bergmann KE Bergmann RL Schulz J Grass T Wahn U Prediction of atopic disease in the newborn :methodological aspects Clin Exp Allergy 1990 20 21 26 9 Liu CA Wang CL Chuang H Ou CY Hsu TY Yang KD Prenatal prediction of infant atopy by maternal but not paternal total IgE levels J Allergy Clin Immunol 2003 112 899 904 14610477 10 Michel FB Bousquet J Greillier P Robinet-Levy M Coulomb Y Comparison of cord blood immunoglobulin E concentrations and maternal allergy for the prediction of atopic diseases in infancy J Allergy Clin Immunol 1980 65 422 430 7372964