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. 2021 Sep 24;8(10):843.
doi: 10.3390/children8100843.

Atopic Manifestations in Children Born Preterm: A Long-Term Observational Study

Federica Pagano  1 , Maria Giulia Conti  1   2 , Giovanni Boscarino  1 , Chiara Pannucci  1 , Lucia Dito  1 , Daniela Regoli  1 , Maria Di Chiara  1 , Giuseppe Battaglia  1 , Rita Prota  1 , Bianca Cinicola  1 , Anna Maria Zicari  1 , Marina Aloi  1 , Salvatore Oliva  1 , Gianluca Terrin  1
Affiliations

Atopic Manifestations in Children Born Preterm: A Long-Term Observational Study

Federica Pagano et al. Children (Basel). .

Abstract

(1) Background: Preterm birth exposes the infant to the known risk factors for atopic diseases. We aimed to study the neonatal risk factors and to describe the clinical manifestations of atopy, including the march of symptoms, in a cohort of preschool children born preterm. (2) Methods: We enrolled neonates with gestational age < 32 weeks or birth weight < 1500 g. We classified patients in cases and controls according to the presence of at least one atopic manifestation. (3) Results: We observed 72 cases and 93 controls. Multivariate models showed that the administration of more than one cycle of antibiotics (B 0.902, p = 0.026) and gestational diabetes (B 1.207, p = 0.035) influence the risk of atopy in babies born preterm. In addition, risk of atopic dermatitis was influenced by gestational age < 29 weeks (B -1.710, p = 0.025) and gestational diabetes (B 1.275, p = 0.027). The risk of wheeze was associated with familiarity for asthma (B 1.392, p = 0.022) and the administration of more than one cycle of antibiotics (B 0.969, p = 0.025). We observed a significant reduction in the rate of atopic manifestation after 2 years of life (33.9% vs. 23.8%, p < 0.05). (4) Conclusions: Modifiable (gestational diabetes, antibiotics use) and unmodifiable (familiarity for asthma) conditions influence the risk of atopy in babies born preterm. Extreme prematurity reduces the risk of atopic dermatitis. Preterm babies showed a peculiar atopic march.

Keywords: antibiotic; atopic dermatitis; cow milk protein; follow-up; food allergy; gestational diabetes; wheeze.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart.
Figure 2
Figure 2
Multivariate analysis evaluating the influence of covariates on the risk of atopic manifestation. Notes: n or y, no or yes; f or m, female or male; atb, antibiotics. Prolonged use of antibiotics was defined as the administration of more than 1 cycle of antibiotics during the neonatal period.
Figure 3
Figure 3
Atopic march in the study population. Notes: * p value < 0.05.
Figure 4
Figure 4
Atopic manifestation before and after 2 years of life in the study population. Notes: * p value < 0.05.
See this image and copyright information in PMC

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