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Bronchopulmonary dysplasia as a risk factor for asthma in school children and adolescents: A systematic review
S Pérez Tarazona1, P Solano Galán2, E Bartoll Alguacil2
1Division of Neonatology, University & Polytechnic Hospital La Fe, Valencia, Spain.
Insights
Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants. This review found no strong evidence that BPD independently increases asthma risk in children and adolescents beyond prematurity itself.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Epidemiology
Background:
- Bronchopulmonary dysplasia (BPD) is a prevalent chronic lung disease in extremely premature infants.
- Prematurity is a known risk factor for developing asthma in later childhood.
- The independent contribution of BPD to asthma risk requires further investigation.
Purpose of the Study:
- To systematically review existing literature on the association between bronchopulmonary dysplasia (BPD) and asthma in school-aged children and adolescents.
- To determine if BPD confers an additional risk for asthma beyond prematurity.
Main Methods:
- A systematic literature search was conducted in MEDLINE and EMBASE databases.
- Studies published between January 2000 and August 2016 were included.
- The review analyzed 17 studies involving 7433 patients.
Main Results:
- Asthma prevalence was higher in children with a history of prematurity and BPD compared to those without BPD.
- This difference in asthma prevalence did not consistently reach statistical significance across studies.
- Significant heterogeneity in diagnostic criteria for BPD and asthma was noted, along with potential confounding factors.
Conclusions:
- Current evidence does not support BPD as an independent risk factor for asthma in school-aged children and adolescents.
- Further high-quality research with standardized diagnostic criteria for BPD and asthma is necessary.
- Clarifying the independent role of BPD in pediatric asthma development remains an open question.
Background:
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that mainly affects extremely pre-term infants, and remains the most common complication of prematurity. Several studies have shown that prematurity predisposes to the development of asthma in school children and adolescents. Nevertheless, it is not clear to what extent a history of BPD involves an additional risk.
Methods:
A systematic review of studies assessing the association between BPD and asthma in school-children and adolescents was made. A literature search was carried out in the MEDLINE and EMBASE databases to retrieve articles published between 1 January 2000 and 31 August 2016.
Results:
A total of 17 studies comprising 7433 patients were included in the review. There was considerable heterogeneity in the definitions of BPD and asthma among studies. Overall, the prevalence of asthma was higher in children and adolescents with a history of prematurity and BPD compared with those who did not develop BPD. However, in only one of the studies did this difference reach statistical significance. The main limitation of this review was potential bias due to the lack of adjustment for confounding factors between exposure (BPD) and outcome (asthma) in most of the studies.
Conclusion:
Based on the studies reviewed, it cannot be argued that BPD, as an independent factor of prematurity, increases the risk of asthma defined by clinical parameters in school-children and adolescents. Further studies of greater methodological quality and homogeneous diagnostic criteria of BPD and asthma are needed for improved assessment of this association.
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