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Published on: August 7, 2017
The increased susceptibility to airway infections after preterm birth does not persist into adolescence
Anne Louise de Barros Garioud1, Frederikke Høeg Skoven1, Rasmus Gregersen1
1Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Insights
Preterm birth increases childhood airway infections, but this risk diminishes in adolescence. While ex-preterm children had higher infection rates, adolescents born preterm showed no increased hospital admissions for these conditions.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Preterm birth is linked to increased childhood airway infections, antibiotic use, and hospitalizations.
- The long-term impact of preterm birth on respiratory health into adolescence is not well understood.
Purpose of the Study:
- To investigate if the association between preterm birth and airway infections persists into adolescence.
Main Methods:
- Longitudinal observational register-based study of Danish births (1992-2007).
- Used antibiotic purchases and hospital admissions as proxies for airway infections.
- Analyzed associations between gestational age, age, and infection proxies using logistic regression.
Main Results:
- Preterm birth was associated with higher rates of prescribed antibiotics and hospital admissions for airway infections in childhood.
- This association diminished in adolescence, with no increased hospital admissions for ex-preterm individuals.
- Adolescents born preterm showed decreased antibiotic purchases compared to term-born peers.
Conclusions:
- The increased risk of airway infections associated with preterm birth in childhood does not appear to persist into adolescence.
- Further research is needed to understand the long-term physiological implications and trends into adulthood.
Introduction:
Preterm birth is associated with increased risk of airway infections in childhood, more frequent purchase of prescription antibiotics and hospital admissions for airway infections. With this study, we aimed to investigate whether this association persists into adolescence.
Methods:
We conducted a longitudinal observational register-based study of a national cohort of all infants born in Denmark in 1992-2007. We used purchase of antibiotics, including penicillins and macrolides, and hospital admissions as proxies for milder and more severe forms of airway infections respectively in 1995-2010. Associations between gestational age (GA), age, year and repeated cross-sectional evaluations of antibiotic purchase and hospital admissions were explored by logistic regression analyses.
Results:
We included 1,043,411 children in our study population. We found a statistically significant association between GA and prescription of antibiotics as well as hospital admissions due to airway infections. In the youngest age groups, children with higher GA had lower adjusted mean rates of prescribed antibiotics for airway infections, but from the age of 10-11 years the opposite trend was noted in what appears to be a dose-response relationship. During childhood, we found an inverse dose-response relationship where ex-preterms with GA 23-27 at age 4-5 years had twice the odds of hospital admission compared to children in the same age group born at term. During adolescence, these higher odds diminished and appeared equivalent among teenagers born at term and preterm. We only found statistically significant interactions between gestational age and age.
Conclusion:
We confirmed that preterm birth is associated with higher rates of prescribed antibiotics and higher odds of hospitalization for airway infections during childhood. However, in adolescence we found that there was no increase in hospital admissions for airway infections among ex-preterms, whereas adolescents with low GA actually appeared to purchase less prescribed antibiotics. Whether this trend persists into adulthood and the physiological explanation therefor remains to be investigated.
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