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Recurrent wheezing in very preterm infants
Insights
Recurrent wheezing is common in very preterm infants, affecting 14.5%. Key risk factors include parental asthma history, maternal smoking, and neonatal lung injury from prematurity.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Epidemiology
Background:
- Wheezing respiratory illnesses are a significant concern in infancy.
- Understanding risk factors for recurrent wheezing is crucial for early intervention, especially in vulnerable populations like preterm infants.
Purpose of the Study:
- To determine the prevalence of recurrent wheezing requiring bronchodilator treatment in the first year of life.
- To identify specific risk factors associated with recurrent wheezing in very preterm infants.
Main Methods:
- Prospective cohort study of very preterm infants (< 33 weeks gestation) and a comparison group of term newborns.
- Collection of parental history and neonatal data, including maternal smoking, siblings, breastfeeding, and respiratory symptoms.
- Assessment at 12 months of age for recurrent wheezing and related factors.
Main Results:
- The incidence of recurrent wheezing was significantly higher in very preterm infants (14.5%) compared to term infants (3%).
- Identified risk factors in very preterm infants included parental asthma history, maternal smoking, presence of siblings at home, and neonatal oxygen supplementation at 28, 36, and 40 weeks gestation.
- Neonatal lung injury and degree of prematurity were implicated as contributing factors.
Conclusions:
- Recurrent wheezing is a common condition among very preterm infants.
- Risk factors are largely consistent with those in term infants but are compounded by prematurity and potential neonatal lung injury.
- These findings highlight the need for targeted respiratory support and monitoring in very preterm infants.
Aims:
To document the prevalence of, and identify risk factors for, recurrent wheezing treated with bronchodilators in the first year of life.
Methods:
Parental history and neonatal data were collected prospectively in a regional cohort of very preterm infants (< 33 weeks). Data on maternal smoking, siblings at home, breast feeding, respiratory symptoms, and hospital re-admissions were documented at 12 months.
Results:
Outcome data were available for 525/560 (95%) of survivors. The incidence of recurrent wheeze was 76/525 (14.5%) in very preterm infants and 20/657 (3%) in a cohort of term newborns. Significant risk factors for recurrent wheeze in very preterm infants were parental history of asthma, maternal smoking, siblings at home, neonatal oxygen supplementation at 28 days, 36, and 40 weeks of gestation.
Conclusions:
Wheezing respiratory illnesses are common in very preterm infants. The factors involved are similar to those in more mature infants, with the addition of immaturity and neonatal lung injury.