Gestational age at birth and wheezing trajectories at 3-11 years

Area of Science:

• Pediatric respiratory health
• Perinatal epidemiology
• Childhood asthma research

Background:

• Preterm birth is a known risk factor for early childhood asthma.
• Long-term respiratory outcomes in preterm infants require further investigation.

Purpose of the Study:

• To assess if the increased risk of asthma and wheezing associated with preterm birth persists into later childhood (7 and 11 years).
• To examine the association between different wheezing trajectories and preterm birth.
• To identify specific gestational age thresholds for increased respiratory risk.

Main Methods:

• Utilized data from the UK Millennium Cohort Study, following children from 9 months to 11 years.
• Estimated adjusted odds ratios (aOR) for wheeze and asthma medication use at ages 7 and 11 based on gestational age categories (<32, 32-33, 34-36, 37-38 weeks vs. 39-41 weeks).
• Analyzed wheezing trajectories: 'early-remittent', 'late', and 'persistent/relapsing'.

Main Results:

• Births before 32 weeks gestation significantly increased the risk of wheeze and asthma medication use at ages 7 and 11.
• A substantial risk for 'persistent/relapsing wheeze' was observed for infants born <32 weeks (aOR=4.30) and 32-33 weeks (aOR=2.06).
• Births between 34-36 weeks were associated with 'early-remittent' and 'persistent/relapsing' wheeze but not with late wheeze or medication use at 7/11 years.

Conclusions:

• Preterm birth, particularly before 37 weeks gestation, is a significant risk factor for developing 'early-remittent' or 'persistent/relapsing' wheeze.
• The findings highlight the long-term respiratory implications of preterm birth, extending beyond early childhood.
• Gestational age is a critical determinant of wheezing patterns and asthma risk throughout childhood.