Respiratory infections in preterm infants and subsequent asthma: a cohort study

Montgomery, Scott; Bahmanyar, Shahram; Brus, Ole; Hussein, Oula; Kosma, Paraskevi; Palme-Kilander, C.

doi:10.1136/bmjopen-2013-004034

Cited by 25 publications

(25 citation statements)

References 33 publications

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“…In this analysis the overlapping hazard ratios across the various gestational age categories suggests the relationship of early and recurrent ARI with increased risk of later respiratory hospitalisation and asthma is similar in preterm infants and late term infants. MONTGOMERY et al [27] conducted a similar analysis of a large Swedish population cohort. The authors did report effect modification with gestational age with the risk of subsequent asthma after 5 years, but only in those born at <28 weeks gestation and they did not explore recurrent ARI in infancy.…”

Section: Discussionmentioning

confidence: 99%

Infant respiratory infections and later respiratory hospitalisation in childhood

2015

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Acute respiratory infections (ARI) cause significant morbidity in infancy. We sought to quantify the relationship between ARI and development of respiratory morbidity in early childhood.Population-based longitudinal hospitalisation data were linked to perinatal, birth and death records for 145 580 Western Australian children from 1997 to 2002. We conducted Cox regression with sensitivity analyses to quantify the risk of recurrent ARI in infancy for respiratory hospitalisation after the age of 3 years.ARI in infancy was significantly related to respiratory hospitalisation before (hazard ratio (HR) 3.5, 95% CI 3.1-3.8) and after (HR 3.0, 95% CI 2.6-3.4) adjusting for known risk factors including maternal smoking during pregnancy, season of birth, delivery mode and gestational age. We noted a dose response with the number and length of infant ARI hospitalisations and increasing risk with no effect modification by gestational age. Results were similar when later respiratory hospitalisations were restricted to asthma hospitalisations only.Recurrent hospitalisations for ARI in infancy significantly increase the risk of respiratory morbidity and asthma requiring hospitalisation after the age of 3 years in a dose-response fashion. The increase in relative risk is not modified by gestational age. Efforts to reduce the occurrence of infant ARI are likely to have significant public health benefits. @ERSpublications Recurrent infant acute respiratory infections: the major predictor of later hospitalisation for respiratory morbidity http://ow.ly/NVmGv

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Section: Discussionmentioning

confidence: 99%

Infant respiratory infections and later respiratory hospitalisation in childhood

2015

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“…Even though the majority of the data on the long-lasting impact of RSV have been based on studies of healthy term-born infants, limited studies have demonstrated increased risk of asthma [68], recurrent wheeze [34,69,70] and lung function impairments [66] in preterm children with a history of RSV-related hospitalisation during infancy. Early-life hospitalisation with RSV infection in preterm infants has been associated with more than twice the risk of ongoing respiratory morbidity, with wheezing rates ranging from 20.7 to 42.8%, 1–2 years following RSV-related hospitalisation compared to 4.1 to 23% following non-RSV related hospitalisation [43].…”

Section: Viral Infection Requiring Readmission In Early Lifementioning

confidence: 99%

“…Early-life hospitalisation with RSV infection in preterm infants has been associated with more than twice the risk of ongoing respiratory morbidity, with wheezing rates ranging from 20.7 to 42.8%, 1–2 years following RSV-related hospitalisation compared to 4.1 to 23% following non-RSV related hospitalisation [43]. The risk of asthma, recurrent wheeze and long-lasting impairments in lung function following severe RSV-related respiratory illness during infancy is more pronounced among preterm infants with BPD [66,71] and those born at a lower gestational age [68]. Although most studies demonstrating persistent respiratory morbidity following RSV-related respiratory illness have focused on hospitalised infants, a single study has demonstrated persistent airway resistance at 1 year of age in preterm infants following mild RSV infection that did not require hospitalisation [72].…”

Section: Viral Infection Requiring Readmission In Early Lifementioning

confidence: 99%

The impact of respiratory viruses on lung health after preterm birth

Townsi

Laing

Hall

et al. 2018

European Clinical Respiratory Journal

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Children born preterm, less than 37 weeks’ gestation, are at increased risk of viral respiratory infections and associated complications both during their initial birth hospitalisation and in their first years following discharge. This increased burden of viral respiratory infections is likely to have long term implications for lung health and function in individuals born preterm, particularly those with bronchopulmonary dysplasia. Several hypotheses have been put forward to explain the association between early life viral respiratory infection and development of suboptimal lung health and function later in life following preterm birth. Although preterm infants with diminished lung function, particularly small airways, might be particularly susceptible to asthma and wheezing disorders following viral infection, there is evidence that respiratory viruses can activate number of inflammatory and airway re-modelling pathways. Therefore, the aim of this review is to highlight the perinatal and early life risk factors that may contribute to increased susceptibility to viral respiratory infections among preterm infants during early life and to understand how respiratory viral infection may influence the development of abnormal lung health and function later in life.

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“…A birth cohort from Sweden consisting of 42 334 children hospitalised for respiratory infections during their first year of life [112] was compared with 211 594 control subjects. It was found that experiencing a viral or bacterial respiratory infection at ,12 months old resulted in a 50% higher risk of asthma at 5 years of age; this increased risk of asthma persisted up to 16 years of age.…”

Section: Viral Respiratory Infectionsmentioning

confidence: 99%

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

et al. 2014

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Chronic obstructive respiratory disorders such as asthma and chronic obstructive pulmonary disease often originate early in life. In addition to a genetic predisposition, prenatal and early-life environmental exposures have a persistent impact on respiratory health. Acting during a critical phase of lung development, these factors may change lung structure and metabolism, and may induce maladaptive responses to harmful agents, which will affect the whole lifespan.Some environmental factors, such as exposure to cigarette smoke, type of childbirth and diet, may be modifiable, but it is more difficult to influence other factors, such as preterm birth and early exposure to viruses or allergens.Here, we bring together recent literature to analyse the critical aspects involved in the early stages of lung development, going back to prenatal and perinatal events, and we discuss the mechanisms by which noxious factors encountered early on may have a lifelong impact on respiratory health.We briefly comment on the need for early disease biomarkers and on the possible role of ''-omic'' technologies in identifying risk profiles predictive of chronic respiratory conditions. Such profiles could guide the ideation of effective preventive strategies and/or targeted early lifestyle or therapeutic interventions. @ERSpublications Early-life factors have a role in onset of asthma and COPD; early postnatal interventions may promote lung health http://ow.ly/BvUrx

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Respiratory infections in preterm infants and subsequent asthma: a cohort study

Cited by 25 publications

References 33 publications

Infant respiratory infections and later respiratory hospitalisation in childhood

Infant respiratory infections and later respiratory hospitalisation in childhood

The impact of respiratory viruses on lung health after preterm birth

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

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