Prematurity, atopy, and childhood asthma in Puerto Ricans

• Published in: Journal of allergy and clinical immunology Vol. 133; no. 2; pp. 357 - 362.e8
• Main Authors: Rosas-Salazar, Christian, MD, Ramratnam, Sima K., MD, Brehm, John M., MD, MPH, Han, Yueh-Ying, PhD, Boutaoui, Nadia, PhD, Forno, Erick, MD, MPH, Acosta-Pérez, Edna, PhD, Alvarez, María, MD, Colón-Semidey, Angel, MD, Canino, Glorisa, PhD, Celedón, Juan C., MD, DrPH
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2014; Elsevier; Elsevier Limited
• Subjects: Adolescent; Allergies; Allergy and Immunology; Asthma; Asthma - epidemiology; Asthma - ethnology; atopy; Biological and medical sciences; Case-Control Studies; Child; Childhood asthma; Children & youth; Chronic obstructive pulmonary disease, asthma; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hispanic Americans; Humans; Hypersensitivity - epidemiology; Hypersensitivity - ethnology; Immunopathology; Infant, Premature; Male; Medical sciences; Pneumology; Pregnancy; Premature Birth - epidemiology; Premature Birth - ethnology; prematurity; Puerto Rican; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Womens health; Central America; Puerto Rico; America; West Indies; United States > US; FVC; prematurity; OR; ETS; Neonatal intensive care unit; Forced vital capacity; atopy; NICU; Odds ratio; Puerto Rican; Childhood asthma; Environmental tobacco smoke; Human; Allergy; Lung disease; Immunopathology; Respiratory disease; Asthma; Atopy; Immunology; Prematurity; Bronchus disease; Obstructive pulmonary disease; Child
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2013.09.003

Background Puerto Rican children share a disproportionate burden of prematurity and asthma in the United States. Little is known about prematurity and childhood asthma in Puerto Rican subjects. Objective We sought to examine whether prematurity is associated with asthma in Puerto Rican children. Methods We performed a case-control study of 678 children aged 6 to 14 years with (n = 351) and without (n = 327) asthma living in San Juan, Puerto Rico. Prematurity was defined by parental report for our primary analysis. In a secondary analysis, we only included children whose parents reported prematurity that required admission to the neonatal intensive care unit. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for analysis. All multivariate models were adjusted for age, sex, household income, atopy (≥1 positive IgE level to common allergens), maternal history of asthma, and early-life exposure to environmental tobacco smoke. Results In a multivariate analysis there was a significant interaction between prematurity and atopy on asthma ( P  = .006). In an analysis stratified by atopy, prematurity was associated with a nearly 5-fold increased odds of asthma in atopic children (adjusted odds ratio, 4.7; 95% CI, 1.5-14.3; P  = .007). In contrast, there was no significant association between prematurity and asthma in nonatopic children. Similar results were obtained in our analysis of prematurity requiring admission to the neonatal intensive care unit and asthma. Conclusions Our results suggest that atopy modifies the estimated effect of prematurity on asthma in Puerto Rican children. Prematurity might explain, in part, the high prevalence of atopic asthma in this ethnic group.