Aoyama Brianna C, Collaco Joseph M, Agarwal Amit, Akangire Gangaram, Austin Eric D, Bansal Manvi, Bhandari Anita, Ioana Cristea A, Hayden Lystra P, Levin Jonathan C, Manimtim Winston M, Miller Audrey N, Moore Paul E, Popova Antonia P, Rhein Lawrence M, Sheils Catherine A, Abman Steven H, Baker Christopher D, Dawson Sara K, Abul Mehtap Haktanir, Henningfeld Jennifer K, Lagatta Joanne M, Siddaiah Roopa, Stephenson Nicole, Toprak Demet, McGrath-Morrow Sharon A
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD, USA.
Division of Pulmonary Medicine, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Pediatr Res. 2025 Jul 11. doi: 10.1038/s41390-025-04277-6.
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.
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.
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.
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.
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.
特应性病史与足月儿的呼吸道疾病相关；然而，关于过敏/特应性如何影响支气管肺发育不良（BPD）患儿的呼吸结局，人们知之甚少。本研究旨在描述BPD幼儿中报告的过敏/特应性的患病率，并评估过敏/特应性是否与门诊结局相关。
利用常规临床问诊时发放问卷收集的数据，对在门诊BPD诊所随访的0至36个月大的儿童进行了一项回顾性纵向队列研究。过敏/特应性的存在由照料者问卷确定。使用广义估计方程来调整过敏/特应性与呼吸结局之间的关联。
一组BPD婴幼儿中报告的过敏/特应性发生率（21.6%）与先前发表的健康儿童发生率相似。与非特应性同龄人相比，特应性/过敏儿童更可能早产、患有肺动脉高压、为非白人和非西班牙裔，并且在生命的头三年中出现呼吸困难、夜间症状、活动受限和使用急救药物的情况。
在BPD患儿中，过敏/特应性在早产患儿中更为常见，并且与生命的头3年中呼吸道症状增加显著相关。需要进一步研究来评估过敏/特应性与呼吸道疾病增加之间的关联是否在整个儿童期持续存在并影响后期肺功能，以及包括吸入性类固醇在内的潜在干预措施是否可以改变这种风险。
关于支气管肺发育不良（BPD）患儿特应性/过敏的患病率以及该人群中过敏/特应性与呼吸结局之间的关联的数据有限。我们的研究结果表明，在BPD患儿中，过敏/特应性在早产患儿中更为常见，并且与生命的头3年中呼吸道症状增加和使用急救药物相关。需要进一步研究来确定这种关联是否在整个儿童期持续存在并影响后期肺功能，以及潜在干预措施是否可以改变这种风险。
