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Asthma and atopic dermatitis in children born moderately and late preterm

Paula Haataja^1,2, Päivi Korhonen^3,4, Riitta Ojala^3,4

¹Pirkanmaa Hospital District, Department of Pediatrics, Tampere University Hospital, PL 2000, 33520, Tampere, Finland. paula.haataja@pshp.fi.

European Journal of Pediatrics

|February 23, 2016

Insights

Moderately preterm (MP) and late preterm (LP) children require more asthma medication and hospitalizations than term-born infants, but less than very preterm (VP) infants. Atopic dermatitis hospitalizations increased with gestational age in preterm infants.

Area of Science:

Pediatrics
Neonatology
Allergy and Immunology

Background:

Preterm birth is associated with increased risks of respiratory morbidity and asthma.
The occurrence of atopic dermatitis in moderately preterm (MP) and late preterm (LP) infants is less understood.
This study investigates asthma and atopic dermatitis outcomes in preterm infants up to age seven.

Purpose of the Study:

To evaluate asthma medication needs and hospitalizations for asthma and atopic dermatitis in moderately preterm (MP), late preterm (LP), and very preterm (VP) children compared to term-born children.
To identify risk factors for asthma medication in MP and LP children.
To analyze the relationship between gestational age and atopic dermatitis hospitalizations.

Main Methods:

A national register study involving 1,018,302 children born in Finland between 1991 and 2008.
Comparison of asthma medication reimbursement and hospitalization rates for asthma and atopic dermatitis among VP, MP, LP, and term-born children up to age seven.
Statistical analysis to identify predictors of asthma medication in MP and LP children.

Main Results:

MP and LP children had higher asthma medication reimbursement (8.0%, 5.7%) and asthma hospitalizations (10.6%, 7.3%) than term controls (3.8%, 4.8%), but lower rates than VP children (15.4%, 20.1%).
Hospitalization for atopic dermatitis was more frequent in term children (5.2%) compared to MP (4.2%) and LP (4.7%) children.
Male sex, maternal smoking, maternal diabetes, and ventilator therapy predicted asthma medication in MP and/or LP children.

Conclusions:

MP and LP children experience increased asthma-related medication needs and hospitalizations compared to term infants, though less than VP infants.
Atopic dermatitis hospitalizations show a trend of increasing with higher gestational age.
Gestational age is a significant factor influencing respiratory and allergic outcomes in early childhood.

Read full analysis

Abstract

Unlabelled:

This national register study aimed to evaluate the need of asthma medication reimbursement and hospitalization due to asthma and atopic dermatitis up to 7 years of age in moderately preterm (MP) (32-33 weeks) and late preterm (LP) (34-36 weeks) children compared to very preterm (VP) (<32 weeks) and term (≥37 weeks) children. Altogether, 1,018,302 children born in Finland between 1991 and 2008 were assessed. The MP and LP groups received asthma medication reimbursement more frequently than term controls (8.0 and 5.7 vs. 3.8 %), but less frequently than VP children (15.4 %). Hospitalization due to asthma was more common among MP (10.6 %) and LP (7.3 %) children than term children (4.8 %) but less common than in VP children (20.1 %). Hospitalization due to atopic dermatitis was more frequent among term (5.2 %) compared to MP (4.2 %) and LP (4.7 %) children. Male sex, maternal smoking, maternal diabetes, and ventilator therapy predicted asthma medication in the MP and/or LP children.

Conclusion:

MP and LP children seem to need medication and hospitalization for asthma more often than term controls but less frequently than VP children followed by 7 years of age. Hospitalization due to atopic dermatitis becomes more common with increasing gestational age.

What Is Known:

• MP and LP infants have an increased risk for early respiratory morbidity and to asthma. • Less is known on the occurrence of atopic dermatitis in this patient group. What is New: • Medication and hospital care due to asthma were more frequent in school-aged MP and LP than in term infants. Male sex, maternal smoking, maternal diabetes and ventilator therapy predicted asthma. • Hospitalization due to atopic dermatitis became more common with increasing gestational age.

Keywords:

Asthma Atopic dermatitis Late preterm Moderately preterm Preterm

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