PREDICTORS FOR THE BRONCHIAL ASTHMA DEVELOPMENT IN CHILDREN WITH BRONCHOPULMONARY DYSPLASIA

Abstract

Frequency of development and characteristics of the course of bronchial asthma (BA) in premature infants with bronchopulmonary dysplasia (BPD) remains controversial problem as yet. In particular, there is insufficient data on predictors of the development of BA in children with BPD. The purpose of this research was to find the predictors for the development of BA in children with BPD. Materials and methods used: a single-center retrospective (2004 to 2023) cohort study of 1724 records of pediatric patients aged 3 months to 18 years old with BA and a history of BPD. The study used a clinical anamnestic method, determination of the number of eosinophils, concentrations of total and specific IgE to allergens in the blood, examination of external respiratory function, a bronchodilation test for the diagnosis of BA and univariate regression analysis. Results: BA developed in 174 (10%) of the 1724 BPD cases. The chance for the BA development in children with BPD is statistically significantly increased by late prematurity (OR 2.257; 95% CI 1.02-4.99; p=0.044), familiar BA history (OR 18.765; 95% CI 11.46-30, 70; p<0.001), concomitant atopic dermatitis (AD) (OR 26.709; 95% CI 13.38-53.31; p<0.001) and allergic rhinitis (AR) (OR 126.849; 95% CI 61.66-260.7; p<0.001), the presence of episodes of wheezing in the first 3 years of life (OR 3.589; 95% CI 2.60-4.94; p<0.001). In patients with BPD, each episode of wheezing in the second year of life increases the risk for the BA development by 1.804 times (95% CI 1.57-2.06; p<0.001) and by 3.425 times (95% CI 2.63-4.44; p<0.001) if it was in the third year of life. Conclusion: predictors for the BA development in children with BPD are late prematurity (gestational age 34 to 36 weeks), familiar BA history, presence of concomitant AD and AR, episodes of wheezing during the first 3 years of life, especially after reaching the age of 1 year old.