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Atopic diseases in pediatric population: prematurity and small for gestational age
Yi-Yu Su1,2, Chi-Jen Chen3, Mei-Huei Chen4,5
1Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Room 733, 17 Xu-Zhou Road, Taipei, 10055, Taiwan.
Insights
Prematurity increases risks for asthma and allergic rhinitis in children but lowers atopic dermatitis risk. Small-for-gestational-age status showed no link to these pediatric atopic diseases.
Area of Science:
- Pediatric Health
- Allergy and Immunology
- Perinatal Medicine
Background:
- Atopic diseases (asthma, atopic dermatitis, allergic rhinitis) are common in children.
- Prematurity and small-for-gestational-age (SGA) status impact long-term health.
- Understanding these links is crucial for early intervention.
Purpose of the Study:
- To investigate the association between prematurity, SGA status, and atopic disease development in children.
- To analyze risks of specific atopic conditions in relation to birth status.
Main Methods:
- Utilized Taiwan's National Health Insurance Research Database (NHIRD) for a nationwide longitudinal cohort.
- Included over 1.7 million infants born between 2004-2019.
- Employed Kaplan-Meier analysis and Cox proportional hazards models for risk assessment, adjusting for covariates.
Main Results:
- Premature infants showed increased risks for allergic rhinitis (AR) and asthma.
- Prematurity was associated with a decreased risk of atopic dermatitis (AD).
- Small-for-gestational-age (SGA) status in term infants was not linked to atopic diseases.
Conclusions:
- Prematurity is a significant factor for developing certain pediatric atopic diseases.
- SGA status in term infants does not appear to influence atopic disease risk.
- Further research is needed to elucidate mechanisms and causality.
Background:
Atopic diseases, including asthma, atopic dermatitis (AD), allergic rhinitis (AR), and food allergy, are significant chronic conditions in the pediatric population. Prematurity and small-for-gestational-age (SGA) status are critical factors influencing long-term health outcomes. This study investigated the associations between prematurity, SGA, and the development of atopic diseases in children using a nationwide longitudinal cohort.
Methods:
We analyzed data from Taiwan's National Health Insurance Research Database (NHIRD), which includes nearly all residents. The cohort comprised infants born between January 1, 2004, and December 31, 2019, excluding those with early death and multiple births. Premature or SGA infants were designated as study cases, while term, appropriate-for-gestational-age (AGA) infants served as controls. Kaplan-Meier analysis estimated cumulative incidence, and log-rank tests compared disease risk across groups. Cox proportional hazards models, adjusted for demographics, pregnancy-related factors, socioeconomic status, and urbanization, were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).
Results:
A total of 1,758,460 infants (914,713 males; 843,747 females) were included. Prematurity was associated with increased risks of AR (HR, 1.03) and asthma (HR, 1.19 in males; HR, 1.17 in females) but a lower risk of AD (HR, 0.94 in males; HR, 0.95 in females) in the AGA group. SGA was not associated with atopic diseases in term infants.
Conclusion:
Prematurity was linked to higher risks of asthma and AR and a lower risk of AD, while SGA status showed no association with atopic diseases in term infants. Further studies are needed to clarify underlying mechanisms and assess causality.
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