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Published on: August 7, 2017
Impact of Prematurity and Severe Viral Bronchiolitis on Asthma Development at 6-9 Years
Maria Luz Garcia-Garcia1, Ersilia Gonzalez-Carrasco2, Teresa Bracamonte1
1Pediatrics Department, Severo Ochoa University Hospital, Fundación IDIPHISA, Alfonso X El Sabio University Madrid, Spain. Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.
Insights
Preterm birth significantly increases childhood asthma risk. Severe bronchiolitis, particularly with rhinovirus or viral coinfections, further elevates this risk in premature infants.
Area of Science:
- Pediatric Respiratory Medicine
- Asthma Research
- Neonatal Outcomes
Background:
- Premature birth heightens susceptibility to viral infections and chronic airway issues.
- Preterm infants, including moderate and late preterm, face risks for both short- and long-term respiratory problems.
Purpose of the Study:
- To compare the impact of severe bronchiolitis and prematurity on asthma development in children aged 6-9 years.
- To identify risk factors for asthma in preterm and full-term children following hospitalization for bronchiolitis.
Main Methods:
- Retrospective cohort study of preterm (<37 weeks GA) and full-term children hospitalized for bronchiolitis.
- Comparison with a control group of preterm children without bronchiolitis admission.
- Asthma assessment using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, lung function tests, and aeroallergen sensitization evaluation.
Main Results:
- Asthma prevalence at 6-9 years was higher in preterm cases (27%) than full-term cases (15%) and preterm controls (14%).
- For hospitalized children, prematurity, rhinovirus, viral coinfection, and paternal asthma were significant risk factors.
- In preterm children, bronchiolitis admission and aeroallergen sensitization increased asthma risk.
Conclusions:
- Preterm birth is a critical early-life risk factor for childhood asthma.
- Severe bronchiolitis, especially due to specific viral infections, amplifies asthma risk in preterm infants.
- Early identification and management of risk factors are crucial for preventing childhood asthma.
Background:
Premature birth is associated with increased susceptibility for viral infections and chronic airway morbidity. Preterm children, even moderate and late, may be at risk for short- and long-term respiratory morbidities.
Objective:
Our main goal was to compare the burden of two conditions, severe bronchiolitis and prematurity (early and moderate-late), on asthma development at 6-9 years.
Patients And Methods:
A retrospective cohort of all preterm (<37weeks gestational age) and full-term children hospitalized for bronchiolitis, with current age between 6 and 9 years, was created. A second cohort was made up of preterm children, without admission for bronchiolitis, randomly chosen from the hospital premature births database. Prevalence and risk factors for asthma were analysed. Parents completed the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaire for asthma symptoms for children 6-7 years. Lung function and aeroallergen sensitization were evaluated.
Results:
Of the 480 selected children, 399 could be contacted and agreed to participate: 133 preterm and 114 full-term cases with admission for bronchiolitis and 146 preterm control children without admission for bronchiolitis. The frequency of current asthma at 6-9 years was higher in preterm cases (27%) compared with full-term-cases (15%) and preterm controls (14%) (p=0.04). Among hospitalized-bronchiolitis children, prematurity (p=0.04), rhinovirus infection (p=0.03), viral coinfection (p=0.04) and paternal asthma (p=0.003) were risk factors for asthma at 6-9 years. Among premature children, with and without bronchiolitis admission, the risk factors for asthma at 6-9 years were admission for bronchiolitis (p=0.03) and aeroallergen sensitisation (p=0.01). Moderate and late preterm children without admission for bronchiolitis showed similar prevalence of current asthma than full-term ones, previously admitted for bronchiolitis.
Conclusion:
Preterm birth is an important early life risk factor for asthma in childhood. The addition of other risk factors, such as severe bronchiolitis, especially by rhinovirus or viral coinfections, are associated with even higher risk for subsequent asthma.
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