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Peer-reviewedCC BYRespiratory research & clinical practice

Prevalence and factors associated with the development of asthma in a cohort of children who were preterm infants and received passive immunization with palivizumab

  • Mariana Bueno Manini1
  • Natali Caroline da Silva1,2
  • Gabriela do Amaral Gurgel Cruz3
  • André Moreno Morcillo4
  • José Dirceu Ribeiro2,4
  • Adyléia Aparecida Dalbo Contrera Toro2,4
4 affiliations
  1. 1. Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil.
  2. 2. Centro de Investigação em Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil.
  3. 3. Faculdade de Medicina, Pontifícia Universidade Católica de Campinas - PUCCAMP - Campinas (SP) Brasil.
  4. 4. Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil.
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Abstract

Objective

To assess the prevalence of asthma in a cohort of preterm infants, comparing those who received prophylaxis with palivizumab, a monoclonal antibody against respiratory syncytial virus (RSV), with those who did not. That is relevant because RSV infection has been linked to recurrent wheezing and asthma in childhood, but a causal relationship remains unclear.Methods

This was a prospective cohort study involving children who were preterm infants without congenital heart disease, exposed or not to palivizumab. Parents or legal guardians answered a telephone questionnaire adapted from the International Study of Asthma and Allergies in Childhood, which covers respiratory symptoms, allergy history, and potential risk factors.Results

Among 292 eligible children, 217 were included (149 in the palivizumab group and 68 in the control group). Of those 217 infants, 25.3% (95% CI:19.9-31.5%) had asthma: 24.2% (95% CI: 17.8-31.5%) in the palivizumab group and 27.9% (95% CI: 18.3-39.5%) in the control group, with no significant difference (p = 0.553). In the bivariate analysis, asthma was significantly associated with a family history of atopy (p < 0.001), parental asthma (p = 0.006), allergic rhinitis in the child (p < 0.001), and atopic dermatitis in the child (p = 0.022). In the multivariate analysis, asthma remained associated with a family history of atopy (adjusted OR = 4.16; 95% CI: 1.77-9.79), allergic rhinitis in the child (adjusted OR = 5.10; 95% CI: 2.59-10.02), and parental asthma (adjusted OR = 2.45; 95% CI: 1.19-5.04).Conclusions

Palivizumab does not seem to protect against asthma development in preterm infants without congenital heart disease. A family history of atopy, parental asthma, and allergic rhinitis in the child seem to be the primary determinants of asthma risk in such infants.

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Cite

BibTeXRIS
BibTeX
@article{manini2026prevalence,
  title = {{Prevalence and factors associated with the development of asthma in a cohort of children who were preterm infants and received passive immunization with palivizumab}},
  author = {Mariana Bueno Manini and Natali Caroline da Silva and Gabriela do Amaral Gurgel Cruz and André Moreno Morcillo and José Dirceu Ribeiro and Adyléia Aparecida Dalbo Contrera Toro},
  journal = {Respiratory research \& clinical practice},
  year = {2026},
  month = nov,
  doi = {10.36416/1806-3756/e20260119},
  url = {https://europepmc.org/article/PMC/PMC13754197},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prevalence and factors associated with the development of asthma in a cohort of children who were preterm infants and received passive immunization with palivizumab
AU  - Mariana Bueno Manini
AU  - Natali Caroline da Silva
AU  - Gabriela do Amaral Gurgel Cruz
AU  - André Moreno Morcillo
AU  - José Dirceu Ribeiro
AU  - Adyléia Aparecida Dalbo Contrera Toro
PY  - 2026
DA  - 2026/11/09
JO  - Respiratory research & clinical practice
DO  - 10.36416/1806-3756/e20260119
UR  - https://europepmc.org/article/PMC/PMC13754197
AB  - Objective  To assess the prevalence of asthma in a cohort of preterm infants, comparing those who received prophylaxis with palivizumab, a monoclonal antibody against respiratory syncytial virus (RSV), with those who did not. That is relevant because RSV infection has been linked to recurrent wheezing and asthma in childhood, but a causal relationship remains unclear.Methods  This was a prospective cohort study involving children who were preterm infants without congenital heart disease, exposed or not to palivizumab. Parents or legal guardians answered a telephone questionnaire adapted from the International Study of Asthma and Allergies in Childhood, which covers respiratory symptoms, allergy history, and potential risk factors.Results  Among 292 eligible children, 217 were included (149 in the palivizumab group and 68 in the control group). Of those 217 infants, 25.3% (95% CI:19.9-31.5%) had asthma: 24.2% (95% CI: 17.8-31.5%) in the palivizumab group and 27.9% (95% CI: 18.3-39.5%) in the control group, with no significant difference (p = 0.553). In the bivariate analysis, asthma was significantly associated with a family history of atopy (p < 0.001), parental asthma (p = 0.006), allergic rhinitis in the child (p < 0.001), and atopic dermatitis in the child (p = 0.022). In the multivariate analysis, asthma remained associated with a family history of atopy (adjusted OR = 4.16; 95% CI: 1.77-9.79), allergic rhinitis in the child (adjusted OR = 5.10; 95% CI: 2.59-10.02), and parental asthma (adjusted OR = 2.45; 95% CI: 1.19-5.04).Conclusions  Palivizumab does not seem to protect against asthma development in preterm infants without congenital heart disease. A family history of atopy, parental asthma, and allergic rhinitis in the child seem to be the primary determinants of asthma risk in such infants.
SN  - 3086-3910
ER  -