Prenatal oxidative balance and risk of asthma and allergic disease in adolescence

J Allergy Clin Immunol. 2019 Dec;144(6):1534-1541.e5. doi: 10.1016/j.jaci.2019.07.044. Epub 2019 Aug 19.


Background: Fetal oxidative balance (achieved when protective prenatal factors counteract sources of oxidative stress) might be critical for preventing asthma and allergic disease.

Objective: We examined prenatal intakes of hypothesized protective nutrients (including antioxidants) in conjunction with potential sources of oxidative stress in models of adolescent asthma and allergic disease.

Methods: We used data from 996 mother-child pairs in Project Viva. Exposures of interest were maternal prepregnancy body mass index and prenatal nutrients (energy-adjusted intakes of vitamins D, C, and E; β-carotene; folate; choline; and n-3 and n-6 polyunsaturated fatty acids [PUFAs]), air pollutant exposures (residence-specific third-trimester black carbon or particulate matter with a diameter of less than 2.5 μm [PM2.5]), acetaminophen, and smoking. Outcomes were offspring's current asthma, allergic rhinitis, and allergen sensitization at a median age of 12.9 years. We performed logistic regression. Continuous exposures were log-transformed and modeled as z scores.

Results: We observed protective associations for vitamin D (odds ratio [OR], 0.69 [95% CI, 0.53-0.89] for allergic rhinitis), the sum of the n-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid (OR, 0.81 [95% CI, 0.66-0.99] for current asthma), and the n-3 PUFA α-linolenic acid (OR, 0.78 [95% CI, 0.64-0.95] for allergen sensitization and OR, 0.80 [95% CI 0.65-0.99] for current asthma). Black carbon and PM2.5 were associated with an approximately 30% increased risk for allergen sensitization. No multiplicative interactions were observed for protective nutrient intakes with sources of oxidative stress.

Conclusions: We identified potential protective prenatal nutrients (vitamin D and n-3 PUFAs), as well as adverse prenatal pro-oxidant exposures that might alter the risk of asthma and allergic disease into adolescence.

Keywords: Asthma; air pollution; allergic sensitization; antioxidants; nutrients; oxidative balance; oxidative stress; pro-oxidants.

Publication types

  • Clinical Trial
  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Asthma / blood*
  • Asthma / etiology
  • Child
  • Child, Preschool
  • Fatty Acids, Omega-3 / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Oxidative Stress*
  • Pregnancy
  • Pregnancy Trimester, Third / blood*
  • Prenatal Exposure Delayed Effects / blood*
  • Rhinitis, Allergic / blood*
  • Rhinitis, Allergic / etiology
  • Vitamin D / blood*


  • Fatty Acids, Omega-3
  • Vitamin D