Family history of asthma influences outpatient respiratory outcomes in children with BPD

Abstract

Introduction Preterm children with bronchopulmonary dysplasia (BPD) are at increased risk for intermittent and chronic respiratory symptoms during childhood and adult life. Identifying children at higher risk for respiratory morbidities in the outpatient setting could help improve long‐term outcomes. In this study, we hypothesized that a family history of asthma (FHA) is a risk factor for higher acute care usage and respiratory symptoms in preterm infants/children with BPD, following initial discharge home. Methods Subjects were recruited from the Johns Hopkins Bronchopulmonary Dysplasia outpatient clinic between January 2008 and February 2020 (n = 827). Surveys were administered to caregivers and demographics and clinical characteristics were obtained through chart review. Results Demographic features associated with FHA included public health insurance, lower median household income, and nonwhite race. Children with FHA had higher odds of emergency department (ED) visits, systemic steroid use, nighttime respiratory symptoms, and activity limitations. There was no association between FHA and BPD severity. Conclusion This study found that children with BPD and FHA were more likely to have respiratory symptoms and acute care usage during the first 3 years of life and that FHA was associated with lower socioeconomic status. Although there was no association between FHA and BPD severity, FHA could predict an increased likelihood of both ED visits and need for systemic steroids in infants/children with BPD followed in the outpatient setting.

Validation of an outpatient questionnaire for bronchopulmonary dysplasia control

“…Conversely, BPD control could also be influenced by genetic factors, such as a family history of asthma. 27 Further work is needed to assess the outpatient influences on preterm respiratory disease.…”

“…However, disease that was partially or not controlled based on sum scores was not associated with any of the demographic factors assessed; this may potentially suggest that other outpatient factors, such as daycare attendance, 21,22 secondhand smoke exposure, 23,24 or exposure to air pollution, 25,26 could play a larger role in disease control than the demographic or clinical characteristics assessed. Conversely, BPD control could also be influenced by genetic factors, such as a family history of asthma 27 . Further work is needed to assess the outpatient influences on preterm respiratory disease.…”

Predictors of Developmental and Respiratory Outcomes Among Preterm Infants With Bronchopulmonary Dysplasia

“…Previous studies have reported that early childhood wheezing is associated with antenatal maternal smoking, atopy, male sex, breastfeeding and other exposure factors ( 24 , 25 ). In the present study, we used machine-learning algorithms to assess the relative significance of various factors on inhaler use.…”