Eduardo G Pérez-Yarza1,2,3, Antonio Moreno-Galdó4, Octavio Ramilo5, Teresa Rubí6, Amparo Escribano7, Antonio Torres8, Olaia Sardón1,3, Concepción Oliva9, Guadalupe Pérez10, Isidoro Cortell11, Sandra Rovira-Amigo4, Maria D Pastor-Vivero12, Javier Pérez-Frías13, Valle Velasco14, Javier Torres-Borrego15, Joan Figuerola16, Maria Isabel Barrio17, Gloria García-Hernández18, Asunción Mejías5. 1. Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia-Instituto Biodonostia, San Sebastián, Spain. 2. Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain. 3. Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain. 4. Pediatric Pulmonary Unit, Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 5. Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. 6. Pediatric Pulmonary Section, Hospital Torrecárdenas, Almería, Spain. 7. Pediatric Pulmonary Unit, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain. 8. Department of Pediatrics, Hospital San Juan de la Cruz, Úbeda, Spain. 9. Pediatric Pulmonary Unit, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain. 10. Pediatric Pulmonary Section, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain. 11. Pediatric Pulmonary Section, Hospital Universitario La Fe, Valencia, Spain. 12. Pediatric Pulmonary Section, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain. 13. Pediatric Pulmonary Unit, Hospital Materno-Infantil, Málaga, Spain. 14. Pediatric Pulmonary Unit, Hospital Clínico Universitario, Tenerife, Spain. 15. Pediatric Pulmonary and Allergy Unit, Hospital Reina Sofía, Córdoba, Spain. 16. Pediatric Pulmonary Section, Hospital Universitario Son Espases, Palma de Mallorca, Spain. 17. Pediatric Pulmonary Section, Hospital Universitario La Paz, Madrid, Spain. 18. Pediatric Pulmonary and Allergy Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Abstract
BACKGROUND: Airway diseases are highly prevalent in infants and cause significant morbidity. We aimed to determine the incidence and risk factors for respiratory morbidity in a Spanish cohort of moderate-to-late preterm (MLP) infants prospectively followed during their first year of life. METHODS: SAREPREM is a multicenter, prospective, longitudinal study. Preterm infants born at 32-35 weeks of gestation with no comorbidities were enrolled within 2 weeks of life and followed at 2-4 weeks, 6, and 12 months of age. Multivariate mixed-models were performed to identify independent risk factors associated with (i) development of bronchiolitis, (ii) recurrent wheezing, or (iii) related hospital admissions. RESULTS: Overall, 977 preterm infants were included, and 766 (78.4%) completed follow-up. Of those, 365 (47.7%) developed bronchiolitis during the first year, 144 (18.8%) recurrent wheezing, and 48 (6.3%) were hospitalized. While low birthweight, day care attendance (DCA) and school-age siblings were significantly and independently associated with both the development of bronchiolitis and recurrent wheezing, lower maternal age increased the risk for bronchiolitis and respiratory-related hospitalizations. Lastly, mechanical ventilation was associated with a higher risk of bronchiolitis and history of asthma in any parent increased the likelihood of developing recurrent wheezing. CONCLUSIONS: In this study, several non-modifiable parameters (family history of asthma, low birthweight, need for mechanical ventilation) and modifiable parameters (young maternal age, DCA, or exposure to school-age siblings) were identified as significant risk factors for the development of bronchiolitis and recurrent wheezing during the first year of life in MLP infants.
BACKGROUND: Airway diseases are highly prevalent in infants and cause significant morbidity. We aimed to determine the incidence and risk factors for respiratory morbidity in a Spanish cohort of moderate-to-late preterm (MLP) infants prospectively followed during their first year of life. METHODS: SAREPREM is a multicenter, prospective, longitudinal study. Preterm infants born at 32-35 weeks of gestation with no comorbidities were enrolled within 2 weeks of life and followed at 2-4 weeks, 6, and 12 months of age. Multivariate mixed-models were performed to identify independent risk factors associated with (i) development of bronchiolitis, (ii) recurrent wheezing, or (iii) related hospital admissions. RESULTS: Overall, 977 preterm infants were included, and 766 (78.4%) completed follow-up. Of those, 365 (47.7%) developed bronchiolitis during the first year, 144 (18.8%) recurrent wheezing, and 48 (6.3%) were hospitalized. While low birthweight, day care attendance (DCA) and school-age siblings were significantly and independently associated with both the development of bronchiolitis and recurrent wheezing, lower maternal age increased the risk for bronchiolitis and respiratory-related hospitalizations. Lastly, mechanical ventilation was associated with a higher risk of bronchiolitis and history of asthma in any parent increased the likelihood of developing recurrent wheezing. CONCLUSIONS: In this study, several non-modifiable parameters (family history of asthma, low birthweight, need for mechanical ventilation) and modifiable parameters (young maternal age, DCA, or exposure to school-age siblings) were identified as significant risk factors for the development of bronchiolitis and recurrent wheezing during the first year of life in MLP infants.
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