Asthma in Premies More Likely To Resolve

There is a well observed and documented phenomenon of increased asthma risk particularly in ex-premies delivered before 30 weeks gestational age.  Parents may be alarmed by the "asthma" label, but that this study suggests that normal child growth and development may help resolve this form of early onset asthma.  Dr. Susarla

Parents of premature babies worry about many things, including an increased risk of asthma. But a large Danish study has found that asthma, common in premature babies, disappears as the children grow older. By the time they are adults, their risk of asthma is no greater than that of babies born full term.

Researchers combed birth and health data on 1.8 million people born from 1980 to 2009, checking for gestational age and neonatal respiratory problems.

The study, published in PLOS One, found that 27 percent of infants born earlier than 27 weeks required asthma medication during childhood, compared with 18 percent of those born at 28-31 weeks, 13 percent at 32-36 weeks, and 9 percent at full term.

But after controlling for socioeconomic status, maternal asthma, multiple birth and other factors, they found that by adolescence, the association had weakened, and by adulthood 2.4 percent of the former preemies required medication compared with 2.1 percent of those born full term, a clinically insignificant difference.

“There are more and more preemies,” said the lead author, Dr. Anne Louise Damgaard, a researcher at the University of Copenhagen, “and we don’t really know what happens to them as they get older. But up to age 31, their lungs are pretty healthy. It’s possible that the differences may become more evident as they age.”

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Lung function changes seen in later childhood in premature infants

Children with history of bronchopulmonary dysplasia, also commonly referred to as chronic lung disease have increased risk for respiratory symptoms in later childhood.  This seems to correlate with lung function changes that can be measured with simple non-invasive office testing. Dr. Susarla

Pulmonary Outcome in Former Preterm, Very Low Birth Weight Children with Bronchopulmonary Dysplasia: A Case-Control Follow-Up at School Age.

Maike Hove, Freerk Prenzel, Holm H Uhlig, Eva Tillig

OBJECTIVE:

To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era.

STUDY DESIGN:

Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire.

RESULTS:

At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group.

CONCLUSION:

Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD.

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Study: Preemies are at a higher risk of asthma

A study shows that babies born prematurely are more likely to develop asthma, although the reason why this is so is not completely understood.

The World Health Organization estimates that 15 million babies are born premature every year, which means they are born before 37 weeks. But new research suggests that risks are higher than previously thought for preterm babies to develop childhood asthma, compared with their full-term counterparts.

Publishing their results in the journal PLoS Medicine, the researchers studied data on more than 1.5 million children around the world.

They used information on patients born since the 1990s from 30 studies, which came from six continents. The majority of the studies came from Europe.

Preterm babies often encounter breathing problems because their lungs are immature, the authors note. They drew from previous research on preterm children born between the 1960s and 1980s, which showed that many of them developed asthma.

However, the researchers say it was unclear whether improved care for preterm babies since then has affected the long-term risk of developing asthma.

Asthma is the most common chronic disease in children, and the team notes that because an increasing number of preterm babies survive birth, the condition is becoming a "significant health problem."

Preterm babies 50% more likely to develop asthma

Overall, the study revealed that while asthma affects 8% of children born at full term, it affects 14% of preterm babies.

In detail, the team found that babies born before 37 weeks were 50% more likely to develop asthma, and those born 2 months early were three times as likely to develop asthma, compared with full-term babies.

Additionally, risks of developing the breathing condition were the same for preschoolers and school-age children, which suggests children who are born early do not outgrow the risk.

"Doctors and parents need to be aware of the increased risks of asthma in premature babies, in order to make early diagnosis and intervention possible," says Dr. Jasper Been, lead study author from the University of Edinburgh's Centre for Population Health Sciences in Scotland.

Dr. Been adds:

"By changing the way we monitor and treat children born preterm, we hope to decrease the future risks of serious breathing problems, including asthma. Our findings should help find better ways to prevent and treat asthma and asthma-like symptoms in those born preterm."

Standard asthma meds 'safe in pregnancy'

The authors say the results of their study provide "compelling evidence" that preterm birth increases asthma risks, and they note that future research "needs to focus on understanding underlying mechanisms, and then to translate these insights into the development of preventive interventions."

But Dr. Samantha Walker, executive director of research and policy at Asthma UK, emphasizes the importance of current asthma medications:

"Standard asthma medicine is very safe to use in pregnancy, and by far the most important way to reduce this risk is for pregnant women to take their medication as prescribed."

She adds that maintaining a healthy weight, staying active, avoiding stress and not smoking are also important measures to keep in mind.

When asked about any further research the team has planned, Dr. Been told Medical News Today:

"An important factor that causes both preterm birth and asthma, particularly in those born preterm, is tobacco smoke exposure before birth. Our current research focuses on evaluating interventions to address this issue."

In other asthma news, a study recently suggested that secondhand smoke is linked to hospital readmission for asthmatic children. The authors of that study believe their findings could prompt insurance companies to give incentives to parents or guardians who quit smoking.

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Turmeric Component Can Prevent Lung Damage in Premature Babies

Perhaps another nod to medicine through better nutrition, curcumin is a known potent antioxidant found in turmeric.  Oxidative injury is thought toplay a major role in bronchopulmonary dysplasia, a chronic lung condition affecting premature infants. Dr Susarla

Turmeric Component Can Prevent Lung Damage in Premature Babies

• A component found in turmeric can prevent lung damage in premature babies, a new study says.
  Babies born before 37 weeks of gestational age are considered to be premature babies. Though most of the internal systems of an unborn baby develop by 32 weeks, according to health experts, lungs remain immature at eight month of pregnancy and take more time to fully develop.
  So when babies are born before completing their gestational age, their lungs are not  fully developed. They require ventilation support and oxygen therapy. However, the therapies have long been found to increase the risk of lung damage, a condition known as bronchopulmonary dysplasia (BPD).  The condition is often accompanied by fluid in lungs and scarring. According to the American Lung Association, between 5,000 and 10,000 babies are affected with BPD every year. 
  The study reported in the American Journal of Physiology, Lung Cellular and Molecular Physiology, found a component in turmeric, known as curcumin, effective in protecting babies against the risk of the lung damage (BPD) and hyperoxia- a condition that is caused by excess oxygen in the body.  Premature babies often suffer from this condition nearly 21 days after birth.  
  The findings are based on the experiments conducted by a team of researchers from Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), with the help of disease models.
  "This is the first study to find long-term benefits of using curcumin to protect lung function in premature infants," Virender K. Rehan, author of the study, said in a news release. "Curcumin is known to have potent antioxidant, anti-inflammatory and anti-microbial properties, making it a promising therapy for premature infants who require oxygen therapy after birth."
  Preterm birth is the leading cause of newborn deaths and the second leading cause of death among children aged below 5 in the world. In the U.S. more than half a million babies are born prematurely. Apart from BPD, premature babies are affected by a series of health problems, including apnea; respiratory distress syndrome; jaundice; anemia; problems related to intestines (Necrotizing enterocolitis -NEC) and infections, particularly to lungs, blood, brain and spinal cord.
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Does IVF Increase Risk for Asthma?

The cause of this association is not clear, but premature infants especially under 30 weeks gestation seem to be more prone to develop asthma symptoms like recurrent wheezing.  Dr. Susarla

Fertility treatment 'asthma link'

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In a study of more than 13,000 UK children, five-years-olds were about twice as likely to have asthma if they were not conceived naturally.Children born after fertility treatments, such as IVF, may have a slightly higher chance of developing asthma, research suggests.

The children were also more likely to need medication, which could be an indication of more severe asthma.

The findings were published in the journal Human Reproduction.

The researchers, at the Universities of Oxford and Essex, analysed data from children born between 2000 and 2002.

Researcher Dr Claire Carson said 15% of all the children in the study had had asthma at the age of five, but this proportion had risen to 24% among the 104 of them born through assisted-reproduction technologies.

She said it was interesting that the pattern had emerged, but far too soon to say if IVF treatment resulted in higher rates of asthma. Other explanations, such as genetics, may explain the association.

Dr Carson told the BBC that parents should not be put off IVF.

"Assisted reproduction technologies offer a chance to become a parent when there isn't another option," she said.

"For the majority of children asthma is quite manageable."

Malayka Rahman, from the charity Asthma UK, said: "This study suggests that there might be an association between IVF treatment and asthma developing in children, but the sample size for this study is small and currently the research in this area generally is not conclusive.

"Those considering IVF should speak to their GP about the benefits and health risks in order to make an informed decision."

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