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Respiratory infections in preterm infants and subsequent asthma: a cohort study

Scott Montgomery1, Shahram Bahmanyar, Ole Brus

  • 1Clinical Epidemiology and Biostatistics, Örebro University Hospital & Örebro University, Örebro, Sweden.

BMJ Open
|November 1, 2013
PubMed

Insights

Infants born extremely preterm who experience early-life respiratory infections face a significantly higher risk of developing asthma later in childhood. This risk is most pronounced for those born before 28 weeks gestation.

Area of Science:

  • Pediatric respiratory health
  • Neonatal outcomes
  • Epidemiology of asthma

Background:

  • Early-life respiratory infections are common in infants.
  • Asthma development is influenced by various factors, including early exposures.
  • The role of gestational age in modifying infection-asthma risk is not fully understood.

Purpose of the Study:

  • To determine if gestational age modifies the association between first-year hospital admission for airway infections and subsequent asthma risk.
  • To investigate the long-term respiratory sequelae in infants following early-life infections.

Main Methods:

  • A Swedish national register study matched 42,334 infants hospitalized for respiratory infection in their first year with 211,594 uninfected controls.
  • Asthma diagnoses and treatments after age 5 were identified via registers.
  • Cox regression analysis was used, with stratification by gestational age.

Main Results:

  • Infants hospitalized for respiratory infection in the first year had a 1.51-fold increased risk of asthma after age 5.
  • Gestational age significantly modified this association, with the highest risk (HR 2.22) seen in infants born before 28 weeks.
  • This elevated asthma risk persisted beyond age 10, diminishing by age 16.

Conclusions:

  • Extremely preterm infants (born <28 weeks) are at the highest risk for chronic respiratory problems after early-life infections.
  • Early respiratory infections in extremely preterm infants are strongly linked to later asthma development.
  • Gestational age is a critical factor in the long-term respiratory health outcomes following early-life infections.
Abstract

Keywords:
bronchiolitiscohort studygestational age

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