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Repercussions of preterm birth on symptoms of asthma, allergic diseases and pulmonary function, 6-14 years later
C Gonçalves1, G Wandalsen2, F Lanza2
1Department of Pediatrics - Neonatal Division of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
Insights
Children born prematurely often experience asthma and impaired lung function. This study found high rates of allergic sensitization and altered pulmonary function in these children, with bronchopulmonary dysplasia and wheezing as key risk factors.
Area of Science:
- Pediatrics
- Pulmonology
- Allergology
Background:
- Preterm birth is associated with increased risk of allergic diseases and impaired pulmonary function in children.
- Assessing these risks is crucial for early intervention and management.
Purpose of the Study:
- To evaluate pulmonary function, asthma, atopic diseases, and allergic sensitization in children born prematurely.
- To identify risk factors associated with altered pulmonary function in this population.
Main Methods:
- A cross-sectional study included 84 children (6-14 years) born prematurely (<2000g birth weight).
- Methods included the International Study of Asthma and Allergies in Childhood questionnaire, skin prick tests, and spirometry.
- Exclusion criteria: major malformations or acute respiratory disorders.
Main Results:
- High prevalence observed: current asthma (25%), rhinitis (38.1%), positive skin prick test (69.6%).
- Altered pulmonary function detected in 42.9% of participants.
- Risk factors for altered pulmonary function included oxygen dependency at 28 days, childhood wheezing, and infant height.
Conclusions:
- Children born prematurely exhibit a high prevalence of severe asthma, allergic sensitization, and impaired pulmonary function.
- Bronchopulmonary dysplasia and a history of wheezing are significant risk factors for altered pulmonary function.
Background:
Prevalence of allergic diseases and impaired pulmonary function may be high in children born prematurely. This study aimed to assess pulmonary function and prevalence of asthma, atopic diseases and allergic sensitisation in these patients.
Methods:
A cross-sectional study was conducted with children aged 6-14 years who were born prematurely with birth weight <2000g from January 2008 to May 2011. Exclusion criteria were: major malformations, or acute respiratory disorders. The International Study of Asthma and Allergies in Childhood questionnaire was applied followed by allergic skin prick test and spirometry.
Results:
The study included 84 children aged 9.3±2.3 years born at mean gestational age of 31.8±2.4 weeks. The prevalence of current asthma was 25%, more severe asthma was 15.5%; rhinitis was 38.1%; flexural eczema was 8.3%; and a positive skin-prick test was 69.6%. Frequencies of children with values <80% of predicted were: FVC (8.3%), FEV1 (22.6%), and FEV1/FVC ratio (16.7%). Prevalence of children with FEF25-75% <70% of the predicted value was 32.4%, positive bronchodilator response was observed in 20.5% of cases, and altered pulmonary function in 42.9%. Factors associated with altered pulmonary function were oxygen dependency at 28 days of life (OR: 4.213, p=0.021), the presence of wheezing in childhood (OR: 5.979, p=0.014) and infant's height (OR: 0.945, p=0.005).
Conclusions:
There was a high prevalence of severe asthma, allergic sensitisation, and altered pulmonary function among children and adolescents born prematurely. Bronchopulmonary dysplasia and a history of wheezing were risk factors for altered pulmonary function.
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