Atopic Manifestations in Children Born Preterm: A Long-Term Observational Study

Abstract

(1) Background: Preterm birth exposes the infant to the known risk factors for atopic diseases. We aimed to study the neonatal risk factors and to describe the clinical manifestations of atopy, including the march of symptoms, in a cohort of preschool children born preterm. (2) Methods: We enrolled neonates with gestational age <32 weeks or birth weight <1500 g. We classified patients in cases and controls according to the presence of at least one atopic manifestation. (3) Results: We observed 72 cases and 93 controls. Multivariate models showed that the administration of more than one cycle of antibiotics (B 0.902, p = 0.026) and gestational diabetes (B 1.207, p = 0.035) influence the risk of atopy in babies born preterm. In addition, risk of atopic dermatitis was influenced by gestational age <29 weeks (B −1.710, p = 0.025) and gestational diabetes (B 1.275, p = 0.027). The risk of wheeze was associated with familiarity for asthma (B 1.392, p = 0.022) and the administration of more than one cycle of antibiotics (B 0.969, p = 0.025). We observed a significant reduction in the rate of atopic manifestation after 2 years of life (33.9% vs. 23.8%, p < 0.05). (4) Conclusions: Modifiable (gestational diabetes, antibiotics use) and unmodifiable (familiarity for asthma) conditions influence the risk of atopy in babies born preterm. Extreme prematurity reduces the risk of atopic dermatitis. Preterm babies showed a peculiar atopic march.

Complementary Feeding and Growth in Infants Born Preterm: A 12 Months Follow-Up Study

“…We enrolled all newborns with gestational age < 32 weeks or body birth weight < 1500 g, consecutively admitted in Neonatal Intensive Care Unit (NICU) of Policlinico Umberto I, Sapienza University of Rome, from January 2015 to December 2019 and with a follow-up of 12 months. We excluded subjects with major congenital (intestinal and extra-intestinal) malformations, inborn errors of metabolism, born to mother with autoimmune diseases, congenital infection, transfer to other hospital or death within the first 72 h of life, or with incomplete clinical data, lost to follow-up, or that developed food intolerance in the first 12 months [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Respiratory Follow Up of the Premature Neonates—Rationale and Practical Issues

“…In a cohort study performed in Argentina, 65% of the VLBW (very low birthweight neonates—neonates with birthweight < 1500 g [ 35 ]) infants had respiratory tract infections caused by human rhinoviruses [ 40 ]. In the same study, 40% of the infants with bronchiolitis had an HRV infection and only 7% RSV [ 40 ] (it is worth mentioning that the study population did not receive palivizumab prophylaxis). The risk was higher for infants with bronchopulmonary dysplasia [ 40 ].…”

“…In the same study, 40% of the infants with bronchiolitis had an HRV infection and only 7% RSV [ 40 ] (it is worth mentioning that the study population did not receive palivizumab prophylaxis). The risk was higher for infants with bronchopulmonary dysplasia [ 40 ]. Immunology studies [ 41 , 42 ] have shown the effects of the HRV at different levels in the lung.…”

“… Long term pulmonary consequences of the respiratory tract infections in the premature infants [ 40 , 41 , 42 , 49 , 50 ]. …”

Atopic Dermatitis is More than Skin Deep: A Commentary on Atopic Dermatitis and Review of Pertinent Publications from Children 2019–2021

“…Atopic Manifestations in Children Born Preterm: A Long-Term Observational Study. Pagano, F. et al [ 12 ].…”