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This is a prospective birth cohort study assessing the role of maternal and environmental factors on the development of allergic diseases in children. Pregnant mothers will be enrolled and we will examine her skin barrier with skin tape strips (STS) and transepidermal water loss (TEWL), along with blood work. We will then follow her offspring and perform similar testing, along with detailed questionnaires inquiring about exposures such as use of detergents and soaps, sunlight exposure, and pollution exposure. When the infant is around 12 months old, we will contact the family via telephone to see if the child developed any allergic conditions within their first year of life, such as eczema, food allergy, or wheezing. A final questionnaire will be performed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pregnant women with expected delivery in the fall or winter | We will enroll up to 40 women who are expected to deliver in the fall (September, October, November) and winter (December, January, February). We will then follow their infant offspring. |
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| Pregnant women with expected delivery in the spring or summer | We will enroll up to 40 women who are expected to deliver in the spring (March, April, May) and summer (June, July, August). We will then follow their infant offspring. |
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| Infants born in the fall or winter | The infants born to the enrolled mothers will be followed. These are infants born in the fall (September, October, November) or winter (December, January, February). |
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| Infants born in the spring or summer | The infants born to the enrolled mothers will be followed. These are infants born in the spring (March, April, May) or summer (June, July, August). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transepidermal water loss | Diagnostic Test | We will assess the skin with transepidermal water loss (TEWL) by using a condenser-chamber system placed lightly on the skin. This will be performed at baseline, then after every 4 skin tape strips. |
| Measure | Description | Time Frame |
|---|---|---|
| Skin barrier assessment with transepidermal water loss (TEWL) will be done in every infant. | TEWL will be performed in all infants to compare skin barrier assessments between infants born in the fall and winter with those born in the spring and summer. We hypothesize greater skin barrier dysfunction in those born in the fall and winter. | 1 year |
| Skin barrier assessment with skin tape stripping (STS) will be done in every infant. | STS will be performed in all infants to compare skin barrier assessments between infants born in the fall and winter with those born in the spring and summer. We hypothesize greater skin barrier dysfunction in those born in the fall and winter. | 1 year |
| Skin barrier assessment with skin swabs for staphylococcus aureus colonization will be done in every infant. | Skin swabs for staphylococcus aureus colonization will be performed in all infants to compare skin barrier assessments between infants born in the fall and winter with those born in the spring and summer. We hypothesize greater staphylococcus aureus colonization in those born in the fall and winter. | 1 year |
| Skin barrier assessment with TEWL will be performed in every pregnant female and compared to her infant offspring, as well as between other pregnant females giving birth in other seasons. | We will compare the mother's skin barrier with the infant skin barrier to see if there is an association with the mother's skin barrier during pregnancy. We will perform TEWL to assess the degree of water loss before, during, and after skin tape stripping. | 1 year |
| Skin barrier assessment with STS will be performed in every pregnant female and compared to her infant offspring, as well as between other pregnant females giving birth in other seasons. |
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Inclusion Criteria:
Inclusion criteria of the pregnant women:
• Pregnant women at any stage of a singleton pregnancy.
Inclusion criteria of the infant:
• Infant is the offspring of a woman enrolled in the study.
Exclusion Criteria:
Exclusion criteria of all subjects:
Exclusion criteria of the pregnant women:
Exclusion criteria of the infant:
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We will enroll up to 40 pregnant mothers who are expected to deliver in the fall and winter, along with up to 40 pregnant mothers who are expected to deliver in the spring and summer. The infants will then be enrolled and followed in the study.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jessica W Hui, MD | Contact | 3033981245 | huij@njhealth.org |
| Name | Affiliation | Role |
|---|---|---|
| Donald Leung, MD PhD | National Jewish Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Jewish Health | Recruiting | Denver | Colorado | 80206 | United States |
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| ID | Term |
|---|---|
| D006967 | Hypersensitivity |
| D005512 | Food Hypersensitivity |
| ID | Term |
|---|---|
| D007154 | Immune System Diseases |
| D006969 | Hypersensitivity, Immediate |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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We will obtain blood to assess the filaggrin gene mutation status, as filaggrin gene mutations have been associated with increased atopic dermatitis severity and persistence.
Other blood work includes total immunoglobulin E and vitamin D.
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| Skin tape stripping | Diagnostic Test | Adhesive skin sampling discs will be pressed against the skin in a hairless location followed by lifting it free of the skin. The discs will be evaluated for lipid content, protein, and filaggrin byproducts in the collected skin sample. |
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| Blood draw | Diagnostic Test | We will draw blood to look at the vitamin D, total immunoglobulin E (IgE), and the filaggrin gene which is important in maintaining the skin barrier. |
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| Bacterial PCR swab | Diagnostic Test | Skin swab from the superficial skin will be collected to be assessed in the laboratory via PCR for the presence of staphylococcus aureus. |
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We will compare the mother's skin barrier with the infant skin barrier to see if there is an association with the mother's skin barrier during pregnancy. We will perform STS to determine the skin breakdown products.
| 1 year |
| Skin barrier assessment with skin swabs for staphylococcus aureus colonization will be performed in every pregnant female and compared to her infant offspring, as well as between other pregnant females giving birth in other seasons. | We will compare the mother's skin barrier with the infant skin barrier to see if there is an association with the mother's skin barrier during pregnancy. We will perform skin swabs for staphylococcus aureus colonization to determine the presence of colonization. | 1 year |
| Skin barrier assessment with filaggrin gene mutation status will be determined in everyone enrolled, and we will look for the filaggrin gene mutation in both the mother and infant. | The filaggrin gene is important for skin health, and we will assess for common filaggrin gene mutations in everyone enrolled in this study via a blood draw in the mother's and cord blood in the infants. | 1 year |
| Vitamin D levels will be obtained and compared between individuals enrolled in this study. | Vitamin D levels will be obtained by blood draw in the pregnant mother's and cord blood in the infants. We will compare the values according to season of birth, as we hypothesize that the infants born in the fall and winter, along with their mothers, will have a lower vitamin D level. | 1 year |
| Questionnaires regarding exposures will be compared with the skin barrier measurements to understand exposures that lead to increased skin barrier dysfunction. | Questionnaires will be administered to capture exposures during pregnancy, such as detergents, soaps, medications, and sunlight exposure. The answers will be compared with the results of the skin barrier assessment in both pregnant women and their infants to understand which exposures lead to skin barrier dysfunction. | 1 year |
| Questionnaires and a follow up telephone call will allow us to see if infants born in the fall and winter have a higher incidence of allergy development. | Questionnaires and follow up telephone calls when the infant is 12 months old will determine which infants develop allergic conditions, such as atopic dermatitis, food allergy, and wheezing. We will compare the infants born in the fall and winter with those born in the spring and summer to see whether the infants born in the fall and winter have increased risk of developing allergy. | 1 year |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |