Predicting Asthma Severity from Allergic Sensitivity to Cockroaches in Pregnant Inner City Women

Objective: To measure and compare cockroach (CR)-specific immunoglobin E (IgE) in sera from pregnant women with mild, moderate and severe asthma.

Study Design: CR IgE levels were measured in stored sera collected during the Collaborative Perinatal Project. Three matched groups of 93 women were formed: group I (mild), history of asthma but no acute exacerbation; group II (moderate), acute asthma exacerbation; group III (severe), required hospitalization for a diagnosis of status asthmaticus. ANOVA was used to compare the three means.

Results: Mean CR IgE paralleled prenatal asthma severity. Mean values were 6.50, 13.12 and 28.99 kU/L for groups I, II and III, respectively (P = .06). High allergen sensitivity, defined as CR IgE > 60 kU/L, was identified in 8 of the 93 study samples. The prevalence of high allergen sensitivity increased as clinical asthma became more severe. Sixty-two percent (5/8) of the high allergen sensitivity occurred in group III.

Conclusion: There appears to be a positive correlation between sensitivity to CR allergens and asthma severity during pregnancy, and these findings support further evaluation of CR allergen sensitivity as a predictor of asthma severity in pregnancy.