Management of Prematurity-Associated Wheeze and Its Association with Atopy

Area of Science:

• Pediatrics
• Respiratory Medicine
• Neonatology

Background:

• Preterm birth is a known risk factor for childhood respiratory morbidity.
• The influence of genetic predisposition (family history of atopy) and treatment interventions on respiratory outcomes in preterm infants remains unclear.

Purpose of the Study:

• To assess the prevalence of respiratory symptoms, particularly wheezing, in children born preterm compared to those born at term.
• To evaluate the role of family history of atopy and mode of delivery in preterm infants' respiratory health.
• To document drug usage patterns in preterm-born children.

Main Methods:

• A cross-sectional, population-based questionnaire study involving 13,361 preterm infants and 13,361 matched term-born controls, aged 1-10 years.
• Data analysis was stratified by gestational age groups (24-32, 33-34, 35-36, and 37-43 weeks) and age (<5 years and ≥5 years).

Main Results:

• Children born preterm, especially those born earliest (24-32 weeks gestation), exhibited significantly higher rates of wheezing at both <5 and ≥5 years of age compared to term-born controls.
• The increased risk of wheezing associated with prematurity was independent of a family history of atopy.
• Inhaler and bronchodilator usage was greater in preterm groups, particularly the most premature, though efficacy requires further study.

Conclusions:

• Increasing degrees of prematurity are directly associated with a higher incidence of respiratory symptoms in childhood.
• Respiratory symptoms in preterm infants are not influenced by a family history of atopy.
• While bronchodilator use is more frequent in preterm populations, its effectiveness warrants careful evaluation.