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Risk factors for early wheezing in preterm infants: a retrospective cohort study

Xun Chen1, Minjing Yang2, Jun Xie1

  • 1Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Frontiers in Pediatrics
|July 9, 2025
PubMed

Insights

Premature infants face higher risks of early wheezing, with lower gestational age increasing incidence. Factors like small-for-gestational-age (SGA) in extremely preterm infants and male sex/family allergy history in moderately preterm infants are significant risk factors.

Area of Science:

  • Pediatrics
  • Neonatology
  • Respiratory Medicine

Background:

  • Recurrent wheezing in children is complex, with premature birth being a potential contributing factor.
  • Early wheezing in preterm infants is not well understood, necessitating further investigation into associated risk factors.

Purpose of the Study:

  • To analyze the incidence and risk factors of early wheezing in preterm infants.
  • To compare wheezing incidence across different gestational age groups.

Main Methods:

  • A cohort study involving 1,616 children born between 2007 and 2013 from eight hospitals in Guangxi, China.
  • Children were categorized into three groups based on gestational age: GA ≤ 32 weeks (Group A), 32 < GA < 37 weeks (Group B), and 37 ≤ GA < 42 weeks (Group C).
  • Follow-up was conducted via telephone or questionnaire through the sixth year of life to assess early wheezing.

Main Results:

  • Incidence of early wheezing was highest in Group A (GA ≤ 32 weeks), followed by Group B (32-37 weeks), and lowest in Group C (full-term).
  • In Group A, a higher proportion of small-for-gestational-age (SGA) infants experienced early wheezing (P < 0.05).
  • In Group B, male sex (95% CI: 1.611-4.601) and a family history of allergy (95% CI: 1.222-3.411) were identified as significant risk factors for early wheezing.

Conclusions:

  • Lower gestational age is significantly associated with an increased risk of wheezing in infants.
  • Preterm infants exhibit a higher incidence of persistent wheezing compared to full-term infants.
  • Specific risk factors for early wheezing differ based on gestational age, with SGA being relevant for extremely preterm infants (<32 weeks) and male sex/family allergy history for moderately preterm infants (32-37 weeks).
Abstract

Keywords:
allergygestational agepreterm infantsrisk factorswheezing

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