title: Prematurity, atopy, and childhood asthma in Puerto Ricans.
abstract: 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.
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Christian
authors.initials: C
authors.lastname: Rosas-Salazar
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Sima K
authors.initials: SK
authors.lastname: Ramratnam
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: John M
authors.initials: JM
authors.lastname: Brehm
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Yueh-Ying
authors.initials: YY
authors.lastname: Han
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Nadia
authors.initials: N
authors.lastname: Boutaoui
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Erick
authors.initials: E
authors.lastname: Forno
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Edna
authors.initials: E
authors.lastname: Acosta-Pérez
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: María
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Angel
authors.initials: A
authors.lastname: Colón-Semidey
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa. Electronic address: juan.celedon@chp.edu.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Celedón
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000208:ethnology; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology
keywords: Childhood asthma; ETS; Environmental tobacco smoke; FVC; Forced vital capacity; NICU; Neonatal intensive care unit; OR; Odds ratio; Puerto Rican; atopy; prematurity