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Family history of asthma in infants with bronchopulmonary dysplasia
Insights
Genetic factors may influence bronchopulmonary dysplasia (BPD) development. Infants with BPD had more relatives with asthma, suggesting a genetic predisposition for reactive airways may worsen neonatal lung conditions.
Area of Science:
- Neonatology
- Genetics
- Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants.
- The role of genetic factors in BPD development is not well understood.
Purpose of the Study:
- To investigate the potential role of genetic or familial factors in the development of BPD.
- To explore the association between family history of lung diseases and BPD incidence.
Main Methods:
- Case-control study comparing infants with BPD to those with hyaline membrane disease (HMD) but without BPD.
- Detailed family histories of asthma, allergy, and other lung diseases were collected for first and second-degree relatives.
- Infants in both groups required assisted ventilation and high inspired oxygen levels.
Main Results:
- A significantly higher proportion of infants with BPD had relatives with physician-diagnosed asthma compared to the HMD group (P < .01).
- Relatives of BPD infants were also more likely to have been hospitalized for asthma (P < .005).
- No significant differences were observed for other conditions like allergic rhinitis, eczema, or bronchitis.
Conclusions:
- Familial predisposition to asthma may increase the risk of developing BPD.
- Neonatal lung injury may unmask or exacerbate a genetic tendency for airway reactivity, contributing to BPD.
- Further research into genetic susceptibility for BPD is warranted.
Abstract:
The role of genetic or familial factors in the development of bronchopulmonary dysplasia (BPD) has not been evaluated. Detailed histories concerning asthma, allergy, and other lung diseases were obtained on first and second degree relatives of 17 infants with BPD, and 21 infants who had hyaline membrane disease but who did not develop BPD (HMD group). All infants in the BPD and HMD groups had hyaline membrane disease requiring assisted ventilation and greater than 50% inspired oxygen in the first five days of life. The diagnosis of HMD and BPD were made on radiographic and clinical criteria. Of the 17 infants with BPD, 13 had first or second degree relatives with physician-diagnosed asthma, compared to seven of 21 in the HMD group (P less than .01). In addition, a significantly greater number of relatives of BPD infants (P less than .005) had been hospitalized for their asthma as compared to HMD relatives. There were no differences between the groups for allergic rhinitis, eczema, bronchitis, emphysema, chronic cough, smoking, or wheezing with respiratory illnesses. These results suggest the possibility that airways with a genetic predisposition for reactivity may become highly reactive following neonatal lung disorders and their treatment. These irritable airways may then contribute to the development, or progression, or both of BPD.