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Early-term birth is a risk factor for wheezing in childhood: A cross-sectional population study
Martin O Edwards1, Sarah J Kotecha1, John Lowe1
1Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
Insights
Children born early term (37-38 weeks gestation) experience increased respiratory issues and healthcare use throughout childhood. This study highlights the persistent respiratory morbidity in early term-born individuals compared to full term-born peers.
Area of Science:
- Pediatric Health
- Respiratory Medicine
- Neonatal Studies
Background:
- Infants born early term (37-38 weeks gestation) face higher neonatal respiratory risks than full term infants (39-42 weeks gestation).
- Longer-term respiratory health outcomes for early term-born children were previously unclear.
Purpose of the Study:
- To investigate if early term-born children exhibit increased respiratory symptoms and healthcare utilization during childhood compared to full term-born children.
- To assess the long-term respiratory health impact of early term birth.
Main Methods:
- A survey of 13,361 term-born children aged 1-10 years was conducted.
- Respiratory outcomes were assessed via questionnaires, with data supplemented by national health databases.
- Logistic regression models were used to analyze results, controlling for factors like family history of atopy and C-section delivery.
Main Results:
- Early term-born children showed higher rates of neonatal unit admission (OR 1.7) and first-year hospital admission (OR 1.6).
- Children under 5 born early term reported significantly more wheezing (ever: OR 1.5, recent: OR 1.7) compared to full term peers.
- Older early term-born children (over 5) also had increased rates of wheezing (ever: OR 1.4, recent: OR 1.4).
Conclusions:
- Early term birth is associated with significantly increased respiratory morbidity in children.
- Healthcare service utilization is also notably higher in early term-born children compared to full term-born children.
- These increased risks persist even after accounting for mode of delivery and family history of atopy.
Background:
Early term-born (37-38 weeks' gestation) infants have increased respiratory morbidity during the neonatal period compared with full term-born (39-42 weeks' gestation) infants, but longer-term respiratory morbidity remains unclear.
Objective:
We assessed whether early term-born children have greater respiratory symptoms and health care use in childhood compared with full term-born children.
Methods:
We surveyed 1- to 10-year-old term-born children (n = 13,361). Questionnaires assessed respiratory outcomes with additional data gathered from national health databases.
Results:
Of 2,845 eligible participants, 545 were early term-born and 2,300 were full term-born. Early term-born children had higher rates of admission to the neonatal unit (odds ratio [OR], 1.7; 95% CI, 1.2-2.5) and admission to the hospital during their first year of life (OR, 1.6; 95% CI, 1.2-2.1). Forty-eight percent of early term-born children less than 5 years old reported wheeze ever compared with 39% of full term-born children (OR, 1.5; 95% CI, 1.1-1.9), and 26% versus 17% reported recent wheezing (OR, 1.7; 95% CI, 1.3-2.4). Early term-born children older than 5 years reported higher rates of wheeze ever (OR, 1.4; 95% CI, 1.05-1.8) and recent wheezing over the last 12 months than full-term control subjects (OR, 1.4; 95% CI, 1.02-2.0). Increased rates of respiratory symptoms in early term-born children persisted when family history of atopy and delivery by means of cesarean sections were included in logistic regression models.
Conclusion:
Early term-born children had significantly increased respiratory morbidity and use of health care services when compared with full term-born children, even when stratified by mode of delivery and family history of atopy.
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