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Preterm birth reduces the incidence of atopy in adulthood
Mirjami Siltanen1, Karoliina Wehkalampi, Petteri Hovi
1Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
Insights
Young adults born very preterm have a reduced risk of atopy, suggesting early development influences lifelong allergic disease. This study investigated preterm birth and atopy in young adulthood.
Area of Science:
- Immunology and developmental biology
- Allergy and immunology research
- Perinatal and neonatal studies
Background:
- Early-life immunologic pathways are crucial for lifelong health.
- Preterm birth may alter immune development, influencing atopy risk.
- Previous research on preterm birth and adult atopy is inconclusive.
Purpose of the Study:
- To compare atopy incidence in young adults born preterm with very low birth weight (VLBW) to term-born controls.
- To assess atopic predisposition using skin prick tests and IgE levels.
Main Methods:
- Study included 166 VLBW preterm adults and 172 term-born controls.
- Atopy assessed via skin prick tests (6 aeroallergens) and serum IgE (total and specific).
- Logistic/linear regression adjusted for confounding factors; self-reported diagnoses of asthma, allergic rhinitis, and atopic eczema were analyzed.
Main Results:
- Reduced risk of positive skin prick tests in VLBW preterm adults (aOR 0.43).
- Lower cat-specific IgE concentrations observed in VLBW preterm adults.
- Earlier gestational age at birth correlated with lower atopy risk within the VLBW group.
Conclusions:
- Young adults born preterm with VLBW exhibit lower atopy incidence than term-born individuals.
- Findings support the hypothesis that early developmental stages significantly determine atopy risk.
- Atopic disease incidence was similar between VLBW adults and controls.
Background:
Immunologic pathways are primed in early life. Preterm birth can influence this process and thereby affect whether a person will have atopy later in life. Previous studies on the effects of preterm birth on atopy in adulthood have been inconclusive and limited to children or subjects born moderately preterm.
Objective:
Our aim was to compare the incidence of atopy among young adults who were born preterm and at very low birth weight (≤ 1500 g) with that of term-born young adults (control subjects).
Methods:
The study comprised 166 adults who were born preterm and at very low birth weight and 172 control subjects, all of whom were from the Helsinki Study of Very Low Birth Weight Adults. We assessed atopic predisposition at ages 18 to 27 years using skin prick tests for 6 common aeroallergens and measurements of serum concentrations of total IgE and 3 types of allergen-specific (cat, birch, and timothy) IgE. We asked the subjects whether they had been given a diagnosis of asthma or allergic rhinitis or had atopic eczema and analyzed data by using logistic or linear regression, adjusting for potential confounding factors.
Results:
The risk for having at least 1 positive reaction on a skin prick test was reduced (adjusted odds ratio, 0.43; 95% CI, 0.23-0.79, P = .007), and the concentration of cat-specific IgE was less (25% less; 95% CI, 43% to 2.3% less; P = .033) in sera from very-low-birth-weight subjects compared with that seen in sera from control subjects. Within the very-low-birth-weight group, those born at an earlier gestational age were less likely to have positive skin prick test reactions (adjusted odds ratio for 1 week, 0.82; 95% CI, 0.68-0.98, P = .029) and less likely to have high levels of allergen-specific IgE. Cumulative incidences of atopic disease were similar between adults of very low birth weight and control subjects.
Conclusions:
Young adults born prematurely and at very low birth weight have a lower incidence of atopy than adults who were born full term. This finding supports the hypothesis that the risk for atopy is determined during early stages of development.
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