A reformulation of the hygiene hypothesis: Maternal infectious diseases confer protection against asthma in the infant

SummaryEpidemiological studies have shown an inverse relationship between allergic respiratory diseases and the number of siblings. It was hypothesized that the lower prevalence of allergic respiratory diseases in large sibships was due to cross-infections between siblings. According to this hygiene hypothesis the increase in the prevalence of atopic diseases is caused by a decrease in the exposure to infections. It was believed that early infections were beneficial for health because of their contribution to the maturation of the immune system. However, in this interpretation a possible protective influence of the mother was overlooked. A new hypothesis is therefore proposed. Maternal exposure to infections induces immunological memory, which protects her children against allergic respiratory diseases.