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. 2025 Dec 13;26(1):50.
doi: 10.1186/s12887-025-06380-3.

Atopic diseases in pediatric population: prematurity and small for gestational age

Yi-Yu Su  1   2 , Chi-Jen Chen  3 , Mei-Huei Chen  4   5 , Ching-Chun Lin  1 , Chin-Kan Chan  6   7 , Wu-Shiun Hsieh  5   8 , Hsi Chang  2   9 , Chung-Ming Chen  2   9 , Hsiu-Chen Lin  9   10 , Pau-Chung Chen  11   12   13   14
Affiliations

Atopic diseases in pediatric population: prematurity and small for gestational age

Yi-Yu Su et al. BMC Pediatr. .

Abstract

Background: Atopic diseases, including asthma, atopic dermatitis (AD), allergic rhinitis (AR), and food allergy, are significant chronic conditions in the pediatric population. Prematurity and small-for-gestational-age (SGA) status are critical factors influencing long-term health outcomes. This study investigated the associations between prematurity, SGA, and the development of atopic diseases in children using a nationwide longitudinal cohort.

Methods: We analyzed data from Taiwan's National Health Insurance Research Database (NHIRD), which includes nearly all residents. The cohort comprised infants born between January 1, 2004, and December 31, 2019, excluding those with early death and multiple births. Premature or SGA infants were designated as study cases, while term, appropriate-for-gestational-age (AGA) infants served as controls. Kaplan-Meier analysis estimated cumulative incidence, and log-rank tests compared disease risk across groups. Cox proportional hazards models, adjusted for demographics, pregnancy-related factors, socioeconomic status, and urbanization, were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results: A total of 1,758,460 infants (914,713 males; 843,747 females) were included. Prematurity was associated with increased risks of AR (HR, 1.03) and asthma (HR, 1.19 in males; HR, 1.17 in females) but a lower risk of AD (HR, 0.94 in males; HR, 0.95 in females) in the AGA group. SGA was not associated with atopic diseases in term infants.

Conclusion: Prematurity was linked to higher risks of asthma and AR and a lower risk of AD, while SGA status showed no association with atopic diseases in term infants. Further studies are needed to clarify underlying mechanisms and assess causality.

Keywords: Allergic rhinitis; Asthma; Atopic dermatitis; Prematurity; Small for gestational age.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study follows the STROBE guidelines for reporting observational studies in epidemiology. The study was approved by the National Health Research Institutes’ Ethics Committee (Approval No: EC1120508-E). Data analysis was performed anonymously, and the requirement for informed consent was waived. All procedures adhered to ethical guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Cumulative incidence of each atopic disease in male infants. Kaplan-Meier survival curves showing the cumulative incidence of asthma, atopic dermatitis (AD), allergic rhinitis (AR), and food allergy in male infants
Fig. 2
Fig. 2
Cumulative incidence of each atopic disease in female infants. Kaplan-Meier survival curves showing the cumulative incidence of asthma, atopic dermatitis (AD), allergic rhinitis (AR), and food allergy in female infants
See this image and copyright information in PMC

References

    1. Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J. 2015. 10.3402/ecrj.v2.24642. - DOI - PMC - PubMed
    1. Pierau M, Arra A, Brunner-Weinzierl MC. Preventing atopic diseases during childhood - early exposure matters. Front Immunol. 2021;12:617731. - DOI - PMC - PubMed
    1. Alkotob SS, et al. Advances and novel developments in environmental influences on the development of atopic diseases. Allergy. 2020;75(12):3077–86. - DOI - PMC - PubMed
    1. Spergel JM. From atopic dermatitis to asthma: the atopic March. Ann Allergy Asthma Immunol. 2010;105(2):99–106. quiz 107–9, 117. - DOI - PubMed
    1. Tsuge M, et al. Current insights into atopic march. Children. 2021. 10.3390/children8111067. - DOI - PMC - PubMed