Risk factors for chronic lung disease and asthma differ among children born extremely preterm

Wesley M Jackson, Thomas Michael O’Shea, Elizabeth N Allred, Matthew M Laughon, William Adam Gower, Alan Leviton

Pediatr Pulmonol. 2018 Aug 29. doi: 10.1002/ppul.24148.

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CLD diagnosed during neonatal admission was associated with bronchodilator use at 12 months and 24 months (P < 0.001), but not with an asthma diagnosis at 10 years (Odds Ratio 1.3; 95% confidence interval 0.98-1.8). While risk factors for CLD include lower gestational age (OR 2.7; 1.5-4.7) and fetal growth restriction (OR 2.3; 1.4-3.7), risk factors for asthma include mother’s eligibility for public insurance (Medicaid) (OR 1.8; 1.1-2.8), and higher weight gain velocity during the first year (OR 1.5; 1.02-2.2) and between the 2nd and 10th year (OR 1.7; 1.2-2.4).

CONCLUSIONS: Among children born EP, the dx of CLD and its antecedents associated with transient preschool wheezing, but not with asthma. Post-NICU factors, such as growth velocity and socioeconomic disadvantage, appear to have stronger associations with asthma than exposures during NICU admission.