Repercussions of preterm birth on symptoms of asthma, allergic diseases and pulmonary function, 6-14 years later.

BACKGROUND: Prevalence of allergic diseases and impaired pulmonary function may be high in children born prematurely. This study aimed to assess pulmonary function and prevalence of asthma, atopic diseases and allergic sensitisation in these patients. METHODS: A cross-sectional study was conducted with children aged 6-14 years who were born prematurely with birth weight <2000g from January 2008 to May 2011. Exclusion criteria were: major malformations, or acute respiratory disorders. The International Study of Asthma and Allergies in Childhood questionnaire was applied followed by allergic skin prick test and spirometry. RESULTS: The study included 84 children aged 9.3±2.3 years born at mean gestational age of 31.8±2.4 weeks. The prevalence of current asthma was 25%, more severe asthma was 15.5%; rhinitis was 38.1%; flexural eczema was 8.3%; and a positive skin-prick test was 69.6%. Frequencies of children with values <80% of predicted were: FVC (8.3%), FEV1 (22.6%), and FEV1/FVC ratio (16.7%). Prevalence of children with FEF25-75% <70% of the predicted value was 32.4%, positive bronchodilator response was observed in 20.5% of cases, and altered pulmonary function in 42.9%. Factors associated with altered pulmonary function were oxygen dependency at 28 days of life (OR: 4.213, p=0.021), the presence of wheezing in childhood (OR: 5.979, p=0.014) and infant's height (OR: 0.945, p=0.005). CONCLUSIONS: There was a high prevalence of severe asthma, allergic sensitisation, and altered pulmonary function among children and adolescents born prematurely. Bronchopulmonary dysplasia and a history of wheezing were risk factors for altered pulmonary function.

Immunophenotypic profile and increased risk of hospital admission for infection in infants born to female kidney transplant recipients.

Children born to female kidney recipients are exposed to immunosuppressive drugs during gestation. Little is known about their immune system at birth or in the long term. Twenty-eight children born to female kidney recipients and 40 full-term children born to healthy mothers were evaluated. T, B, NK, NKT, γδT cells were assessed by flow cytometry and functional evaluation of T and dendritic cells after in vitro activation was performed at birth and at 8 months of age. At birth, infants born to female kidney recipients showed lower numbers of CD4+ T, NKT and intense reduction of B cells (median cells/mm(3) , transplant: 153.7 X control: 512.4; p < 0.001). There was also a reduced percentage of activated CD8+ T and of CD4+ regulatory T cells. Activated memory and exhausted memory B cells showed higher percentages among children exposed to immunosuppressors when compared to control group. At 8 months, most immune alterations were no longer observed, but four children still had low numbers of some lymphocyte subsets at this age. Children born to female kidney recipients had 4.351 (95% CI: 1.026-15.225; p = 0.046) higher risk of hospital admission in the first months of life-some, with severe clinical manifestations-than those born to healthy women.

[Relationship between hypertensive states and perinatal prognosis in abruptio placentae]. / Relação entre os estados hipertensivos e o prognóstico perinatal no descolamento prematuro da placenta.

Ninety-one occurrences of abruptio placentae were analyzed by the Department of Obstetrics of the São Paulo School of Medicine in São Paulo, Brazil during a ten-year period, from 1979 to 1988. The purpose was to analyze perinatal prognosis and its relation to hypertensive states. The authors observed that arterial hypertension was present in 75% of the cases, most of which chronic arterial hypertension; they also observed that perinatal mortality increased in the presence of high arterial blood pressure.