Associations between family history of asthma, bronchopulmonary dysplasia, and childhood asthma in very low birth weight children.

Very low birth weight (VLBW) infants are at risk for childhood wheezing and asthma, as are children with a family history of asthma. Family history of asthma may also be associated with premature labor and, among VLBW infants, with bronchopulmonary dysplasia (BPD) and chronic lung disease (CLD) of prematurity. This study targeted all neonates with birth weight <1,501 g who were admitted to seven perinatal centers in Wisconsin and Iowa between August 1, 1988 and June 30, 1991. Comprehensive information was collected for 723 of the 1,007 30-day survivors, and for 106 full-term controls. A representative subgroup of 257 VLBW children was contacted at age 5 years to ascertain bronchodilator and/or steroid use and diagnosis of asthma. Some evidence of an association between family history of asthma and premature birth was found, but it was not associated with neonatal BPD/CLD or BPD/CLD severity. Among BPD/CLD indicators, radiographic evidence of BPD at age 25-35 days was most strongly associated with bronchodilator use up to age 2 years (odds ratio (OR) = 10.1, 95% confidence interval (CI) 4.07-25.2) and with asthma between ages 2 years and 5 years (OR = 4.83, 95% CI 2.18-10.7). Among children without radiographic evidence of BPD, family history of asthma was associated with childhood asthma and bronchodilator use.