Allergy and atopic phenotype are associated with earlier gestation and severity of respiratory symptoms in bronchopulmonary dysplasia.

BACKGROUND

A history of atopy is associated with respiratory morbidities in term-born children; however, little is known about how allergies/atopy affect respiratory outcomes in children with bronchopulmonary dysplasia (BPD). This study aims to describe the prevalence of reported allergies/atopy in young children with BPD and assess whether allergies/atopy are associated with outpatient outcomes.

METHODS

A retrospective longitudinal cohort study of children between 0 and 36 months of age followed at outpatient BPD clinics was performed using data from questionnaires administered during routine clinical encounters. The presence of allergy/atopy was defined by caregiver questionnaires. Generalized estimating equations were used to adjust associations between allergy/atopy and respiratory outcomes.

RESULTS

Rates of reported allergy/atopy in a cohort of infants and children with BPD (21.6%) were similar to previously published rates in healthy children. Children with atopy/allergy were more likely to be born at earlier gestational ages, have pulmonary hypertension, and be non-white and non-Hispanic compared to their non-atopic peers and to experience trouble breathing, nighttime symptoms, activity limitations, and rescue medication use during the first three years of life.

CONCLUSIONS

In children with BPD, allergy/atopy was more common among those born at earlier gestational ages and was significantly associated with increased respiratory symptoms during the first 3 years of life. Further studies are needed to assess whether the association between allergy/atopy and increased respiratory morbidity persists throughout childhood and affects later lung function and whether potential interventions, including inhaled steroids, may modify this risk.

IMPACT

There is limited data on the prevalence of atopy/allergy in children with bronchopulmonary dysplasia (BPD) and the association between allergy/atopy and respiratory outcomes in this population. Our findings demonstrate that in children with BPD, allergy/atopy was more common among those born at earlier gestational ages and was associated with increased respiratory symptoms and rescue medication use during the first 3 years of life. Further studies are needed to determine whether this association persists throughout childhood and affects later lung function and whether potential interventions may modify this risk.