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DOI: 10.1055/s-0040-1716971
Recurrent Wheezing in a Spanish Cohort of Children Born Moderate-to-Late Preterm in Their First 2 Years of Life
Publication History
Publication Date:
08 September 2020 (online)
Introduction Children born moderate (between week 32 and 336/7 weeks) or late preterm (34 to 366/7 weeks) are known to have higher respiratory morbidity compared with full-term (FT) infants. This is a consequence of a higher incidence of respiratory distress at birth, and of their higher risk for respiratory diseases, especially viral infections. Many studies have reported that these infections, particularly respiratory syncytial virus (RSV) and rhinovirus, are associated with the development of wheezing in the first years of life. Other risk factors related to wheezing are prematurity, familiar history of asthma, siblings, etc.
Our aim was to study the incidence of recurrent wheezing (at least three episodes) in the first 2 years of life in children born moderate-to-late preterm and to analyze the risk factors associated with wheezing in our group.
Materials and Methods We performed a prospective longitudinal cohort study at Hospital Universitario Severo Ochoa (Madrid, Spain). Children born between 2013 and 2014, with gestational age between 32 and 366/7 weeks (n = 202) were included. Epidemiological (family history of asthma and/or atopy, siblings, tobacco exposure, daycare attendance, etc.) and clinical data (type of delivery, respiratory distress at birth, mechanical ventilation, breastfeeding, bronchiolitis, and wheezing) were collected at birth and during their first 2 years of life by ambulatory monitoring. Statistical analysis was performed with SPSS 22.0.
Results Main results are reported in [Table A007]. During the follow-up period, in our group of moderate and late preterm infants, 28.7% (58/202) of infants developed recurrent wheezing. No significant differences were found related to wheezing when analyzing lung maturation, family history of asthma/atopy, breastfeeding, or school-age siblings. Daycare attendance increased the risk of wheezing by more than three times and history of hospital admission due to bronchiolitis (41.5% caused by RSV) increased it by four times.
Conclusion We observed that almost a third of the children of our study developed recurrent wheezing in their first 2 years of life. We found some modifiable risk factors associated with this event, such as attendance to daycare. Other risk factors such as hospital admission due to bronchiolitis could also be modifiable with monoclonal antibodies (Palivizumab, Nirsevimab, etc.) which are known to decrease hospital admission rates due to RSV.
Adjusted or for recurrent wheezing disorder (95% confidence interval) |
p-Value |
|
Daycare attendance |
3,394 (1,729–6,665) |
<0.0001 |
Hospital admission due to bronchiolitis |
4,967 (2a76–1oa83) |
<0.0001 |
History of asthma in siblings |
2,355 (0.855–6,488) |
0.098 |
Breastfeeding during first 12 months of life |
1,289 (0.564–2,944) |
0.547 |
Conflict of Interest
None declared.