Transient Tachypnea of the Newborn and the Association with Preschool Asthma

Abstract

Rationale: Transient tachypnea of the newborn (TTN) is characterized by respiratory distress in neonates, resulting from delayed clearance of fetal lung fluid. Although traditionally considered a self-limited condition, recent studies have indicated a potential association between TTN and an increased risk for respiratory infections during infancy. Objectives: This study investigates the possible link between TTN and healthcare utilization for asthma during childhood. Methods: This retrospective, case-control study used nationwide electronic records from Clalit Healthcare Services, Israel. The study included term infants born between 2011 and 2018 who were diagnosed with TTN (TTN+) and a control group without TTN (TTN-). The primary outcomes were asthma-related healthcare utilization up to age 6 years. Propensity score matching was used to adjust for potential confounders. Results: The study included 645 children with TTN and 187,809 in the TTN- group. In prematching analysis, the TTN+ group had a higher incidence of cesarean delivery and male sex. Postmatching, demographic, and clinical differences were balanced. Children in the TTN+ group had significantly higher rates of emergency room visits for asthma (2.05 times higher; P value (Pv) < 0.001; 95% confidence interval [CI], 1.46-2.89), asthma diagnoses (38% increase; Pv < 0.001; 95% CI, 1.18-1.51), and prescriptions for short-acting β-agonists (28% increase; Pv = 0.002; 95% CI, 1.1-2.89) than control subjects. These associations remained significant after adjusting for confounders. Conclusions: The findings suggest that TTN may be associated with a higher risk of developing asthma in childhood. This study may enhance our understanding of the potential long-term respiratory implications of TTN and could inform clinical follow-up strategies for affected infants.

Keywords: asthma; transient tachypnea of the newborn.