• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (12)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics  • Neonatology and Infant Care  • Pediatrics, Other  • Pulmonary Diseases  • Asthma  • Women's Health  • Pregnancy and Breast Feeding  • Immunology  • Allergy  • Alert me on articles by topic  Social Bookmarking   What's this?

Darios Getahun, MD, MPH; Daniel Strickland, PhD, MSPH; Robert S. Zeiger, MD, PhD; Michael J. Fassett, MD; Wansu Chen, MS; George G. Rhoads, MD, MPH; Steven J. Jacobsen, MD, PhD

Arch Pediatr Adolesc Med. 2010;164(2):187-192.

Objective  To examine the association between chorioamnionitis and childhood asthma based on gestational age at birth and race/ethnicity.

Design  A retrospective cohort study using the Kaiser Permanente Southern California (KPSC) Matched Perinatal records.

Setting  Kaiser Permanente Southern California, Pasadena, California.

Participants  All singleton children born in KPSC hospitals between 1991 and 2007 (N = 510 216).

Main Exposure  Clinically diagnosed chorioamnionitis.

Main Outcome Measures  Physician-diagnosed asthma in children aged 8 years or younger.

Results  The incidence rates of asthma among preterm- and full term–born children of pregnancies complicated by chorioamnionitis were 100.7 and 39.6 per 1000 person-years, respectively (incidence rate ratio, 2.9; 95% confidence interval [CI], 2.6-3.3). Children aged 8 years or younger with asthma were more likely to be born to women who were aged 35 years or older, African American, had 13 or more years of education, had maternal asthma, used antibiotics, had chorioamnionitis during the pregnancy, and had a male child. Multivariable Cox regression analysis revealed that children born at 23 to 28, 29 to 33, and 34 to 36 weeks' gestation after pregnancies complicated by chorioamnionitis had a 1.23-fold (95% CI, 1.02-1.49), 1.51-fold (95% CI, 1.26-1.80), and 1.20-fold (95% CI, 1.03-1.47), respectively, increased risk of asthma compared with children of similar gestational age born after pregnancies not complicated by chorioamnionitis. A preterm pregnancy complicated by chorioamnionitis was associated with increased risk of asthma among white (hazard ratio [HR], 1.66; 95% CI, 1.32-2.07), African American (HR, 1.98; 95% CI, 1.60-2.44), and Hispanic (HR, 1.70; 95% CI, 1.45-2.00), but not Asian/Pacific Islander (HR, 1.15; 95% CI, 0.83-1.58) women.

Conclusion  Findings suggest that chorioamnionitis at preterm gestation is independently associated with increased risk of childhood asthma.

Author Affiliations: Departments of Research and Evaluation (Drs Getahun, Strickland, and Jacobsen, and Ms Chen), Allergy (Dr Zeiger), and Maternal-Fetal Medicine, West Los Angeles Medical Center (Dr Fassett), Kaiser Permanente Southern California Medical Group, Pasadena, California; and the Department of Epidemiology, University of Medicine and Dentistry of New Jersey School of Public Health, Piscataway (Dr Rhoads).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Histologic Chorioamnionitis Is Associated With Reduced Risk of Late-Onset Sepsis in Preterm Infants
Strunk et al.
Pediatrics 2012;129:e134-e141.
ABSTRACT | FULL TEXT  

Association of Late-Preterm Birth With Asthma in Young Children: Practice-Based Study
Goyal et al.
Pediatrics 2011;128:e830-e838.
ABSTRACT | FULL TEXT  

Preterm Birth and Inhaled Corticosteroid Use in 6- to 19-Year-Olds: A Swedish National Cohort Study
Vogt et al.
Pediatrics 2011;127:1052-1059.
ABSTRACT | FULL TEXT