BACKGROUND: Prematurity (< 37 weeks) has been inconsistently associated with asthma and wheezing. Chorioamnionitis may promote both prematurity and inflammatory pathways in infants' airways. OBJECTIVE: To investigate the relationship of prematurity and chorioamnionitis with the development of early childhood recurrent wheezing. METHODS: The Boston Birth Cohort (n = 1096) were followed prospectively from birth to a mean age of 2.2 +/- 2 years. Perinatal and postnatal clinical data and placental pathology were collected. The primary outcome was recurrent wheezing (> or =2 physician documented episodes). Secondary outcomes included physician-diagnosed asthma, food allergy, and eczema. Preterm children were grouped by gestational age into moderately (33-36.9 weeks) and very preterm (< 33 weeks) with and without chorioamnionitis, and compared with term children without chorioamnionitis (reference group). Chorioamnionitis was diagnosed either by intrapartum fever or by placental histology findings. Logistic regression models were performed to investigate the independent and joint associations of degree of prematurity and chorioamnionitis. RESULTS: Prematurity was associated with recurrent wheezing (odds ratio [OR], 1.7; 95% CI, 1.2-2.6). However, when subjects were grouped by degree of prematurity with or without chorioamnionitis, the highest risk of wheezing (OR, 4.0; 95% CI, 2.0-8.0) and physician-diagnosed asthma (OR, 4.4; 95% CI, 2.2-8.7) was present in the very preterm children with chorioamnionitis. The effect on both wheezing (OR, 5.4; 95% CI, 2.4-12.0) and asthma (OR, 5.2; 95% CI, 2.3-11.9) was greater in African Americans. Neither prematurity nor chorioamnionitis was associated with food allergy or eczema. CONCLUSION: We found a strong joint effect of prematurity and chorioamnionitis on early childhood wheezing. This effect was stronger in African American subjects.
BACKGROUND: Prematurity (< 37 weeks) has been inconsistently associated with asthma and wheezing. Chorioamnionitis may promote both prematurity and inflammatory pathways in infants' airways. OBJECTIVE: To investigate the relationship of prematurity and chorioamnionitis with the development of early childhood recurrent wheezing. METHODS: The Boston Birth Cohort (n = 1096) were followed prospectively from birth to a mean age of 2.2 +/- 2 years. Perinatal and postnatal clinical data and placental pathology were collected. The primary outcome was recurrent wheezing (> or =2 physician documented episodes). Secondary outcomes included physician-diagnosed asthma, food allergy, and eczema. Preterm children were grouped by gestational age into moderately (33-36.9 weeks) and very preterm (< 33 weeks) with and without chorioamnionitis, and compared with term children without chorioamnionitis (reference group). Chorioamnionitis was diagnosed either by intrapartum fever or by placental histology findings. Logistic regression models were performed to investigate the independent and joint associations of degree of prematurity and chorioamnionitis. RESULTS: Prematurity was associated with recurrent wheezing (odds ratio [OR], 1.7; 95% CI, 1.2-2.6). However, when subjects were grouped by degree of prematurity with or without chorioamnionitis, the highest risk of wheezing (OR, 4.0; 95% CI, 2.0-8.0) and physician-diagnosed asthma (OR, 4.4; 95% CI, 2.2-8.7) was present in the very preterm children with chorioamnionitis. The effect on both wheezing (OR, 5.4; 95% CI, 2.4-12.0) and asthma (OR, 5.2; 95% CI, 2.3-11.9) was greater in African Americans. Neither prematurity nor chorioamnionitis was associated with food allergy or eczema. CONCLUSION: We found a strong joint effect of prematurity and chorioamnionitis on early childhood wheezing. This effect was stronger in African American subjects.
Authors: Frank D Gilliland; Yu-Fen Li; Louis Dubeau; Kiros Berhane; Edward Avol; Rob McConnell; W James Gauderman; John M Peters Journal: Am J Respir Crit Care Med Date: 2002-08-15 Impact factor: 21.405
Authors: Steffen Kunzmann; Kerstin Glogger; Jasper V Been; Suhas G Kallapur; Ilias Nitsos; Timothy J Moss; Christian P Speer; John P Newnham; Alan H Jobe; Boris W Kramer Journal: Am J Obstet Gynecol Date: 2010-05 Impact factor: 8.661
Authors: Katherine C Wai; Anna M Hibbs; Martina A Steurer; Dennis M Black; Jeanette M Asselin; Eric C Eichenwald; Philip L Ballard; Roberta A Ballard; Roberta L Keller Journal: J Pediatr Date: 2018-04-04 Impact factor: 4.406
Authors: Grace P Tamesis; Ronina A Covar; Matthew Strand; Andrew H Liu; Stanley J Szefler; Mary D Klinnert Journal: J Pediatr Date: 2012-10-01 Impact factor: 4.406
Authors: Rodney D Britt; Arij Faksh; Elizabeth Vogel; Richard J Martin; Christina M Pabelick; Y S Prakash Journal: Expert Rev Respir Med Date: 2013-10-03 Impact factor: 3.772
Authors: Evridiki Patelarou; Maria Chochlidaki; Victoria Vivilaki; Hero Brokalaki Journal: Int J Environ Res Public Health Date: 2009-11-03 Impact factor: 3.390