Association of Late-Preterm Birth With Asthma in Young Children: Practice-Based Study

MSCE, Children's Hospital of Philadelphia, 3535 Market St, Suite 1029, Philadelphia, PA 19104. .
PEDIATRICS (Impact Factor: 5.47). 09/2011; 128(4):e830-8. DOI: 10.1542/peds.2011-0809
Source: PubMed


To evaluate the association of late-preterm birth with asthma severity among young children.
A retrospective cohort study was performed with electronic health record data from 31 practices affiliated with an academic medical center. Participants included children born in 2007 at 34 to 42 weeks of gestation and monitored from birth to 18 months. We used multivariate logistic or Poisson models to assess the impact of late-preterm (34-36 weeks) and low-normal (37-38 weeks) compared with term (39-42 weeks) gestation on diagnoses of asthma and persistent asthma, inhaled corticosteroid use, and numbers of acute respiratory visits.
Our population included 7925 infants (7% late-preterm and 21% low-normal gestation). Overall, 8.3% had been diagnosed with asthma by 18 months. Compared with term gestation, late-preterm gestation was associated with significant increases in persistent asthma diagnoses (adjusted odds ratio [aOR]: 1.68), inhaled corticosteroid use (aOR: 1.66), and numbers of acute respiratory visits (incidence rate ratio: 1.44). Low-normal gestation was associated with increases in asthma diagnoses (aOR: 1.34) and inhaled corticosteroid use (aOR: 1.39).
Birth at late-preterm and low-normal gestational ages might be an important risk factor for the development of asthma and for increased health service use in early childhood.

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    • "Several studies have limited power to detect the modest association we observed [32,33,53,54]. And cross-sectional studies may be vulnerable to recall bias [14,16,17]. As preterm born infants are smaller than fetuses of the same gestational age [39], studies, categorizing SGA based on the distributions of live births [32,33,53] may misclassify SGA as AGA, and thereby dilute a possible association. "
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