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Risk factors for respiratory morbidity in infancy after very premature birth
A Greenough1, E Limb, L Marston
1Department of Child Health, 4th Floor Golden Jubilee Wing, King's College Hospital, Bessemer Road, London SE5 9RS, UK. anne.greenough@kcl.ac.uk
Insights
Male infants born very prematurely face higher risks of infant respiratory problems. Strategies to prevent chronic oxygen dependency are crucial for these vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Public Health
Background:
- Very premature birth (before 29 weeks gestation) poses significant risks for infant respiratory health.
- Respiratory morbidity is a common complication in infants born extremely preterm.
- Identifying risk factors is essential for targeted interventions and improved outcomes.
Purpose of the Study:
- To investigate the incidence of respiratory morbidity in infants following very premature birth.
- To identify specific risk factors associated with increased respiratory morbidity in this population.
Main Methods:
- A prospective follow-up study involving 492 infants born before 29 weeks gestation.
- Data collected via structured questionnaires completed by pediatricians at 6 and 12 months corrected age.
- Respiratory morbidity assessed using measures of cough, wheeze, treatment requirements, and a composite score.
Main Results:
- At 6 and 12 months corrected age, 27% and 20% of infants experienced cough and wheeze, respectively.
- Frequent cough (more than once a week) and frequent wheeze were reported in 6% and 3% of infants.
- Male sex, oxygen dependency at 36 weeks postmenstrual age, younger siblings, and rented accommodation were associated with increased respiratory morbidity.
Conclusions:
- Male infants are particularly susceptible to respiratory morbidity after very premature birth.
- Developing strategies to prevent chronic oxygen dependency is critical for improving infant respiratory health.
- Early identification of risk factors can inform preventative care for extremely preterm infants.
Objectives:
To determine the occurrence of respiratory morbidity during infancy after very premature birth and to identify risk factors.
Design:
Prospective follow up study.
Setting:
The United Kingdom oscillation study.
Patients:
492 infants, all born before 29 weeks gestation.
Interventions:
Structured questionnaires were completed by local paediatricians when the infants were seen in outpatients at 6 and 12 months of age corrected for prematurity.
Main Outcome Measures:
Cough, wheeze, and treatment requirements and the composite measure of respiratory morbidity (cough, frequent cough, cough without infection, wheeze, frequent wheeze, wheeze without infection, and use of chest medicine) and their relation to 13 possible explanatory variables.
Results:
At 6 and 12 months of corrected age, 27% of the infants coughed and 6% had frequent (more than once a week) cough, and 20% and 3% respectively had wheeze or frequent wheeze. At 6 and 12 months, 14% of infants had taken bronchodilators and 8% inhaled steroids. After adjustment for multiple outcome testing, four factors were associated with increased respiratory morbidity: male sex, oxygen dependency at 36 weeks postmenstrual age, having older siblings aged less than 5 years, and living in rented accommodation.
Conclusions:
Male infants are particularly vulnerable to respiratory morbidity in infancy after very premature birth. It is important to identify a safe and effective strategy to prevent chronic oxygen dependency.
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