Neonatal immune regulation transitions from fetal immunity and varies with maturation status, but its role in neonatal cow's milk protein allergy (CMPA) remains unknown. We studied the association between maturation status at birth and neonatal CMPA. Clinical and laboratory data of neonates presenting with CMPA symptoms were retrospectively collected from two tertiary hospitals. Patients were assessed according to gestational age at birth: preterm, late-preterm, and full-term. Fifty-five infants (26 females, 14 preterm, 15 late-preterm, and 26 full-term) were included; 44 were negative for milk-specific IgE. Neonatal CMPA was common during moderately premature periods. Preterm infants exhibited longer latency from initial CM exposure to disease onset, lower incidence of bloody stool, and absence of elevated monocyte counts. However, immunoreactivity to CM antigens was retained in all infants. Neonatal CMPA features varied with infant maturation status at birth. Our results improve the understanding of intestinal immunity development, fetal/neonatal immune regulation, and CMPA pathogenesis.

中文翻译：

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出生时成熟对新生儿牛奶蛋白过敏临床特征的影响：一项回顾性研究。

新生儿免疫调节从胎儿免疫转变而来，并随成熟状态而变化，但其在新生儿牛奶蛋白过敏（CMPA）中的作用仍不清楚。我们研究了出生时成熟状态与新生儿 CMPA 之间的关联。回顾性收集两家三级医院出现 CMPA 症状的新生儿的临床和实验室数据。根据出生时的胎龄对患者进行评估：早产、晚期早产和足月。纳入 55 名婴儿（26 名女性、14 名早产儿、15 名晚期早产儿和 26 名足月儿）； 44 人的牛奶特异性 IgE 呈阴性。新生儿 CMPA 在中早产期很常见。早产儿从最初接触 CM 到发病的潜伏期较长，血便发生率较低，并且单核细胞计数不升高。然而，所有婴儿都保留了对 CM 抗原的免疫反应性。新生儿 CMPA 特征随婴儿出生时的成熟状态而变化。我们的研究结果提高了对肠道免疫发育、胎儿/新生儿免疫调节和 CMPA 发病机制的理解。