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Recurrent respiratory symptoms in the first year of life following preterm delivery
A Greenough1, I Maconochie, B Yuksel
1Department of Paediatrics, King's College Hospital, London, U.K.
Insights
Preterm infants, especially those with very low birth weight (VLBW), experience significantly more recurrent respiratory symptoms in their first year. These symptoms are linked to increased hospital admissions, highlighting a critical need for ongoing respiratory support.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Public Health
Background:
- Preterm birth is associated with increased risks of adverse health outcomes.
- Infants born very low birth weight (VLBW) are particularly vulnerable to respiratory complications.
- Understanding long-term respiratory health in VLBW infants is crucial for early intervention.
Purpose of the Study:
- To investigate the incidence of recurrent respiratory symptoms in the first year of life for preterm VLBW infants.
- To compare respiratory symptom prevalence between preterm VLBW infants and a control group of full-term infants.
- To explore the relationship between respiratory symptoms and hospital admissions in these populations.
Main Methods:
- Two studies were conducted: a questionnaire-based study comparing VLBW infants to controls, and a prospective follow-up of VLBW infants.
- Questionnaires collected data on cough, wheeze, medication use, and hospital admissions.
- Prospective follow-up documented respiratory symptoms and re-admission rates in relation to neonatal ventilation duration.
Main Results:
- Recurrent respiratory symptoms (wheeze or cough) affected 65% of preterm VLBW infants versus 33% of controls (p < 0.001).
- Hospital admissions were more frequent in infants with recurrent wheeze in both groups (p < 0.01).
- In the prospective study, 53% of VLBW infants experienced recurrent wheeze and/or cough.
Conclusions:
- Preterm VLBW infants exhibit a substantially higher burden of recurrent respiratory symptoms in early life.
- Recurrent wheeze is a significant predictor of hospital admissions in both preterm and full-term infants.
- These findings underscore the long-term respiratory vulnerability of VLBW infants post-NICU discharge.
Abstract:
Recurrent respiratory symptoms in the first year of life following preterm delivery were documented in two studies. In the first study a questionnaire was sent to all parents of preterm very low birth weight (VLBW) infants who had been admitted during a six-month period to the Neonatal Intensive Care Unit (NICU) at King's College Hospital (KCH) and who lived within the local district. Questionnaires were also sent to parents of a control group of infants who were recruited by random selection. All the controls lived locally and were delivered at KCH in the same six-month period as the study group, but were born at 37-41 weeks of gestation and had had no neonatal problems. The questionnaire documented frequency of cough and wheeze, medication and hospital admissions. Recurrent respiratory symptoms (wheeze or wheeze and cough) occurred in 65% of the preterm VLBW infants but only 33% of the controls p less than 0.001. Less than 10% of infants in either group had received bronchodilator therapy. Admission to hospital in both groups was more common amongst children who had recurrent wheeze (p less than 0.01). In the second study all preterm VLBW infants admitted to the NICU in a six-month period were followed prospectively over the first year of life. The nature and frequency of respiratory symptoms and frequency and length of re-admission was documented and related to the duration of neonatal ventilation. Twenty-three of the 44 preterm VLBW infants (53%) followed prospectively had recurrent wheeze and/or cough.(ABSTRACT TRUNCATED AT 250 WORDS)