Prenatal heavy metal exposure, total immunoglobulin E, trajectory, and atopic diseases: A 15-year follow-up study of a Taiwanese birth cohort.

Prenatal exposure to heavy metals may cause atopic diseases. Little association between cord blood total immunoglobulin E (CB-tIgE) levels and the occurrence of atopic diseases has been found. This study investigated the atopic status and tIgE trajectory trend in a Taiwanese birth cohort over 15 years. We also assessed the effect of maternal heavy metal exposure on maternal serum cytokine and CB-tIgE levels. We recruited 430 pregnant women during their third trimester in 2000-2001. Maternal urinary heavy metal concentrations and serum cytokine levels were measured. The CB-tIgE and serum tIgE levels of the women's children when they were aged 5, 8, 11, and 14 years were measured. The upper quartile of the maternal urinary arsenic concentration was associated with an increased risk of a CB-tIgE level higher than 1 IU/mL (odds ratio, 1.845; 95% confidence interval, 1.003-3.395). Serum tIgE trajectory levels were the highest in children with asthma, followed by those with atopic dermatitis and allergic rhinitis at the age of 5-14 years. Serum tIgE levels tended to peak at the age of 11 years in the atopic children but were stable from the age of 8 years in the non-atopic children. We first demonstrated that serum tIgE levels reached a trajectory peak in the atopic children aged 11 years. Prenatal exposure to arsenic may increase the risk of elevated CB-tIgE levels. Further investigation is warranted to elucidate the mechanism through which maternal serum cytokines affect the occurrence of atopic diseases in children.