Attending daycare in the primary three years of life is linked with a rise in lung complications in children who were born prematurely and diagnosed with a type of chronic lung disease, in keeping with latest research led by Kid’s Hospital of Philadelphia (CHOP).

The multicenter study, which drew data from nine specialty centers across the USA, found that preterm children with bronchopulmonary dysplasia (BPD) who attend daycare were more more likely to visit the emergency department, use systemic steroids and have chronic respiratory symptoms compared with children not in daycare. The findings were published within the The Journal of Pediatrics.

Preterm children born with BPD have a brief window to enhance their lung function trajectory, so we’re all the time on the lookout for ways to reduce exposures in early childhood to forestall lung function problems in adult life. This study shows that daycare is a modifiable risk factor that’s linked with poorer outcomes in preterm children with BPD.”

Sharon McGrath-Morrow, MD, MBA, Lead Writer, Associate Chief of the Division of Pulmonary and Sleep Medicine and leader of the Post-preemie Lung Disease Clinic at Kid’s Hospital of Philadelphia

Several prior studies have shown an association between daycare attendance and increased risk of respiratory complications in very low birth weight children. Nonetheless, those studies focused on a single center or location and thus the outcomes weren’t generalizable across the population.

To raised qualify the impact of daycare exposure on respiratory illnesses in children with BPD, the researchers collected registry data from nine tertiary care centers in the USA who take part in the BPD Collaborative Outpatient Registry. Analyzing 341 former preterm infants with BPD between the ages of 0 and three, the researchers collected data on daycare attendance, clinical characteristics, acute care use, and chronic respiratory symptoms.

The researchers found that preterm children with BPD who attended daycare were thrice as more likely to visit the emergency room and 4 times as more likely to use systemic steroids. Additionally they observed a greater risk of chronic respiratory symptoms amongst preterm children who attended daycare, including respiration problems (coughing or wheezing) and increased use of rescue medication, comparable to inhalers. There was no difference between children who attended in-home daycares and people who attended center-based daycares.

To find out whether these effects lessened with age, the researchers stratified their data into three age groups: 6-12 months, 12-24 months, and 24-36 months. They found the negative impacts of daycare were highest within the 6-12 months age group, but the information suggested those effects may persist until 36 months of age.

“Many families need childcare outside the house for a wide range of reasons, including caregiver employment,” McGrath-Morrow said. “Providers should advise families with infants and young children with BPD concerning the potential risks of daycare attendance, particularly prior to 1 12 months of age, while also making an allowance for the financial needs of the family.”

Source:

Kid’s Hospital of Philadelphia

Journal reference:

McGrath-Morrow, S.A., et al. (2022) Daycare Attendance is linked to Increased Risk of Respiratory Morbidities in Preterm Children with Bronchopulmonary Dysplasia. The Journal of Pediatrics. doi.org/10.1016/j.jpeds.2022.06.037.