A primary health-care intervention on pre- and postnatal risk factor behavior to prevent childhood allergy. The Prevention of Allergy among Children in Trondheim (PACT) study

Abstract

Background: This study aimed to evaluate the impact of a primary prevention intervention program on risk behavior for allergic diseases among children up to 2 years of age. The setting was in ordinary pre- and postnatal primary health care in Trondheim, Norway.

Methods: The Prevention of Allergy among Children in Trondheim, Norway (PACT) study invited all pregnant women and parents to children up to 2 years of age in the community to participate in a non-randomized, controlled, multiple life-style intervention study. Interventional topics was increased dietary intake of cod liver oil and oily fish for women during pregnancy and for infants during the first 2 years of life, reduced parental smoking and reduced indoor dampness. A control cohort was established prior to the intervention cohort with "follow up as usual". Questionnaires were completed in pregnancy, 6 weeks after birth and at 1 and 2 years of age. Trends in exposure and behavior are described.

Results: Intake of oily fish and cod liver oil increased statistically significantly among women and infants in the intervention cohort compared to the control cohort. There was a low postnatal smoking prevalence in both cohorts, with a trend towards a decreasing smoking prevalence in the control cohort. There was no change in indoor dampness or in behavior related to non- intervened life-style factors.

Conclusions: The dietary intervention seemed to be successful. The observed reduced smoking behavior could not be attributed to the intervention program, and the latter had no effect on indoor dampness.

Trial registrations: (Current Controlled Trials registration number: ISRCTN28090297).

Figure 1

Flow-chart for the PACT-study 2000 - 2009. A total of 7845 participants in the control cohort completed 13647 self-reported questionnaires from 2002-2005. The intervention cohort was completed in March 2009. The arrows to the right in the intervention cohort, shows when and how many participants completed the questionnaires at each scheduled follow up. * Total population of children born in Trondheim during inclusion period. Q1 = Questionnaire on behavior and risk factors at first antenatal check-up during pregnancy. Q2 = Questionnaire on behavior and risk factors at 6 weeks of age. Q3 = Questionnaire on behavior and risk factors at 1 year of age. Q4 = Questionnaire on behavior and risk factors at 2 years of age. In this paper Q2, Q3 and Q4 in both cohorts have been used.