Abstract
(1) Background: Preterm birth exposes the infant to the known risk factors for atopic diseases. We aimed to study the neonatal risk factors and to describe the clinical manifestations of atopy, including the march of symptoms, in a cohort of preschool children born preterm. (2) Methods: We enrolled neonates with gestational age < 32 weeks or birth weight < 1500 g. We classified patients in cases and controls according to the presence of at least one atopic manifestation. (3) Results: We observed 72 cases and 93 controls. Multivariate models showed that the administration of more than one cycle of antibiotics (B 0.902, p = 0.026) and gestational diabetes (B 1.207, p = 0.035) influence the risk of atopy in babies born preterm. In addition, risk of atopic dermatitis was influenced by gestational age < 29 weeks (B −1.710, p = 0.025) and gestational diabetes (B 1.275, p = 0.027). The risk of wheeze was associated with familiarity for asthma (B 1.392, p = 0.022) and the administration of more than one cycle of antibiotics (B 0.969, p = 0.025). We observed a significant reduction in the rate of atopic manifestation after 2 years of life (33.9% vs. 23.8%, p < 0.05). (4) Conclusions: Modifiable (gestational diabetes, antibiotics use) and unmodifiable (familiarity for asthma) conditions influence the risk of atopy in babies born preterm. Extreme prematurity reduces the risk of atopic dermatitis. Preterm babies showed a peculiar atopic march.
Highlights
Over the last 40 years, the worldwide prevalence of allergic diseases has increased considerably [1]
If early administration antibiotics atopic increased the general during risk of atopy, the risk ofof was associated with maternal gestational diabetes and gestational age (GA)
If early administration of antibiotics increased the general risk atopy, the risk of atopic dermatitis (AD) was associated with maternal gestational diabetes and GA at birth, while the occurrence wheeze was with gestational familiarity for asthma
Summary
Over the last 40 years, the worldwide prevalence of allergic diseases has increased considerably [1]. In the last trimester of pregnancy, the fetal immune system adapts to tolerate maternal and self-antigens, while preparing for postnatal immune defense [5,6] Preterm birth, interrupting this “immunological imprinting” and leading the exposure to protective or harmful extrauterine factors such as microbiota and nutritional antigens, may have consequences for the development of immune diseases, such as atopy [5]. Despite this immunological status and despite that preterm birth exposes the infant to most of the aforementioned risk factors, there is no evidence of a higher prevalence of atopy in preterm compared to term-born infants [7]
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