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Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study

Xiao-Mei Mai1, Per-Olof Gäddlin, Lennart Nilsson

  • 1Department of Molecular and Clinical Medicine, Division of Paediatrics, Linköping University, Linköping, Sweden. xiama@imk.liu.se

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|June 6, 2003
PubMed

Insights

Children born with very low birth weight (VLBW) have increased asthma risk by age 12. Neonatal oxygen supplementation is a key risk factor, while VLBW itself doesn

Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Allergy and Immunology

Background:

  • Very low birth weight (VLBW) infants face potential long-term respiratory and allergic health challenges.
  • Understanding the impact of neonatal interventions on later respiratory health in VLBW survivors is crucial.

Purpose of the Study:

  • To investigate the association between very low birth weight (VLBW) and the development of asthma, lung function, and atopy up to 12 years of age.
  • To identify specific neonatal factors contributing to respiratory issues in VLBW children.

Main Methods:

  • Prospective follow-up of 74 VLBW children and 64 matched term-born children for 12 years.
  • Assessment included questionnaires on respiratory and allergic symptoms, spirometry, skin prick tests, and hypertonic saline provocation tests at age 12.
  • Cytokine secretion analysis was performed on stimulated blood leukocyte cultures in a subset of participants.

Main Results:

  • Asthma history was more frequent in VLBW children (22%) compared to term children (9%) by age 12.
  • Neonatal mechanical ventilation and oxygen supplementation were significantly associated with asthma history in univariate analyses.
  • Neonatal oxygen supplementation for >= 9 days was the sole significant predictor in multivariate analysis (adjusted OR 6.7).
  • VLBW children requiring mechanical ventilation showed higher rates of bronchial hyperresponsiveness (60% vs. 28%).
  • Lung function (spirometry) and atopy markers (skin prick tests, allergic symptoms) did not differ significantly between groups.
  • Cytokine levels (IL-4, IL-5, IFN-gamma) were similar between VLBW and term children.

Conclusions:

  • A history of asthma is twice as common in VLBW children by age 12, with neonatal oxygen supplementation being a significant risk factor.
  • Neonatal mechanical ventilation is linked to bronchial hyperresponsiveness at age 12.
  • Very low birth weight itself does not appear to be directly associated with atopy or impaired lung function at 12 years.

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