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Published on: August 7, 2017
Gestational age at birth and risk of allergic rhinitis in young adulthood
Casey Crump1, Kristina Sundquist, Jan Sundquist
1Department of Medicine, Stanford University, Palo Alto, CA, USA. kccrump@stanford.edu
Insights
Infants born earlier, even extremely preterm, had a lower risk of allergic rhinitis medication use in young adulthood. This suggests gestational age at birth may influence later allergy development, potentially due to early pathogen exposure.
Area of Science:
- Perinatal Epidemiology
- Allergy and Immunology
- Public Health
Background:
- Previous research on gestational age, birth weight, and allergic rhinitis had limitations.
- Studies struggled to assess risk in extremely preterm infants or separate gestational age from fetal growth effects.
Purpose of the Study:
- To investigate the association between gestational age at birth and allergic rhinitis medication prescription in young adults.
- To determine if gestational age independently predicts allergic rhinitis risk, controlling for fetal growth.
Main Methods:
- National cohort study of 630,090 Swedish births (1973-1979).
- Followed individuals for allergic rhinitis medication prescriptions (nasal corticosteroids, oral antihistamines) from 2005-2009.
- Included 27,953 preterm infants, analyzing medication data from national pharmacy records.
Main Results:
- Low gestational age at birth correlated with reduced risk of allergic rhinitis medication use in young adulthood.
- Extremely preterm infants (23-28 weeks) showed significantly lower odds of medication prescription compared to full-term births.
- Adjusted odds ratios for extremely preterm infants were 0.70 for nasal corticosteroids and 0.45 for both medication types.
Conclusions:
- Lower gestational age at birth, independent of fetal growth, is linked to decreased allergic rhinitis risk in young adulthood.
- Findings suggest a potential protective effect from earlier exposure to pathogens in preterm infants.
- Gestational age is an independent factor influencing the development of allergic rhinitis.
Background:
Previous studies of the association between gestational age or birth weight and allergic rhinitis in later life have had various limitations, including the inability to estimate risk among subjects born extremely preterm or to examine specific contributions of gestational age and fetal growth.
Objective:
We sought to determine whether gestational age at birth independent of fetal growth is associated with allergic rhinitis medication prescription in a national cohort of young adults.
Methods:
We conducted a national cohort study of 630,090 infants born in Sweden from 1973 through 1979 including 27,953 born preterm (<37 weeks) and followed for prescription of nasal corticosteroids and oral antihistamines in 2005-2009 (age, 25.5-37.0 years). Medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden.
Results:
The overall prevalence of nasal corticosteroid and oral antihistamine prescription was 16.3% and 16.8%, respectively, which is similar to the reported prevalence of allergic rhinitis in this population. Low gestational age at birth was associated with a decreased risk of nasal corticosteroid and oral antihistamine prescription in young adulthood after adjusting for fetal growth and other potential confounders. For subjects born extremely preterm (23-28 weeks), adjusted odds ratios were 0.70 (95% CI, 0.51-0.96) for nasal corticosteroid prescription and 0.45 (95% CI, 0.27-0.76) for both nasal corticosteroid and oral antihistamine prescription relative to those born at full term.
Conclusion:
These findings suggest that low gestational age at birth independent of fetal growth is associated with a decreased risk of allergic rhinitis in young adulthood, possibly because of a protective effect of earlier exposure to pathogens.
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