Birth month and sensitization to house dust mites in asthmatic children

Background: Early exposure to high quantities of allergen has an important role in the incidence of atopic sensitization. In fact, subjects sensitized to house dust mites (HDMs) have a significantly higher proportion of births in the season when HDMs are most abundant. Objective: The aim of this study was to investigate whether birth month patterns differ for asthmatic patients sensitized only to HDMs and for those sensitized to HDMs and other allergen(s). Methods: Among 2225 patients with asthma, aged 10-16 years, 1642 sensitized to HDMs were identified by skin prick testing. This group was composed of patients sensitized only to HDMs (n = 715) and patients sensitized to HDMs and other allergen(s) (n = 927). The birth month distributions of the group of HDM-sensitive asthmatics or its subgroups were compared with that of a reference population (total live births in the same years as the studied subjects). The risk ratio of a given birth month in relation to all the other months was calculated as an odds ratio (OR) with the corresponding 95% confidence interval (CI). Results: A significant difference in birth month distribution was observed for HDM-sensitive asthmatics (χ² = 23.6, P = 0.015), with higher rates of birth in August (OR: 1.23, 95% CI: 1.04-1.46) and September (1.24, 1.04-1.46). When the two subgroups were analyzed separately, significantly more births were noted in August (1.34, 1.06-1.71) and September (1.34, 1.05-1.70) for those sensitized only to HDMs, whereas no such birth month preference was observed for those sensitized to HDMs and other allergen(s). Conclusions: The HDM-positive asthmatics showed a greater proportion of births in August and September, which correspond to high HDM exposure. However, this birth month pattern was evident in asthmatic-sensitive only to HDMs, but was not observed in those sensitive to HDMs and other allergen(s).