Antonio Moreno-Galdó1,2, Eduardo G Pérez-Yarza3,4,5, Octavio Ramilo6, Teresa Rubí7, Amparo Escribano8, Antonio Torres9, Olaia Sardón3,5, Concepción Oliva10, Guadalupe Pérez11, Isidoro Cortell12, Sandra Rovira-Amigo1, Maria D Pastor-Vivero13, Javier Pérez-Frías14,15, Valle Velasco16, Javier Torres17, Joan Figuerola18, María Isabel Barrio19, Gloria García-Hernández20, Asunción Mejías6,15. 1. Pediatric Allergy and Pulmonology Section, Department of Pediatrics, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. CIBERER, Madrid, Spain. 3. Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia San Sebastián, Spain. 4. Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain. 5. Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain. 6. Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. 7. Pediatric Pulmonology Section, Hospital Torrecárdenas, Almería, Spain. 8. Pediatric Pulmonology Unit, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain. 9. Department of Pediatrics, Hospital San Juan de la Cruz, Úbeda, Spain. 10. Pediatric Pulmonary Unit, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain. 11. Pediatric Pulmonology Section, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain. 12. Pediatric Pulmonology Section, Hospital Universitario La Fe, Valencia, Spain. 13. Pediatric Pulmonology Section, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain. 14. Pediatric Pulmonology Unit, Hospital Materno-Infantil, Málaga, Spain. 15. Departamento de Farmacología y Pediatria, Facultad de Medicina, Universidad de Malaga, Málaga, Spain. 16. Pediatric Pulmonology Unit, Hospital Clínico Universitario, Tenerife, Spain. 17. Hospital Reina Sofía, Córdoba, Spain. 18. Pediatric Pulmonology Section, Hospital Universitario Son Espases, Palma de Mallorca, Spain. 19. Pediatric Pulmonology Section, Hospital Universitario La Paz, Madrid, Spain. 20. Pediatric Pulmonology and Allergy Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Abstract
BACKGROUND: Data addressing short- and long-term respiratory morbidity in moderate-late preterm infants are limited. We aim to determine the incidence of recurrent wheezing and associated risk and protective factors in these infants during the first 3 years of life. METHODS: Prospective, multicenter birth cohort study of infants born at 32+0 to 35+0 weeks' gestation and followed for 3 years to assess the incidence of physician-diagnosed recurrent wheezing. Allergen sensitization and pulmonary function were also studied. We used multivariate mixed-effects models to identify risk factors associated with recurrent wheezing. RESULTS: A total of 977 preterm infants were enrolled. Rates of recurrent wheezing during year (Y)1 and Y2 were similar (19%) but decreased to 13.3% in Y3. Related hospitalizations significantly declined from 6.3% in Y1 to 0.75% in Y3. Independent risk factors for recurrent wheezing during Y2 and Y3 included the following: day care attendance, acetaminophen use during pregnancy, and need for mechanical ventilation. Atopic dermatitis on Y2 and male sex on Y3 were also independently associated with recurrent wheezing. Palivizumab prophylaxis for RSV during the first year of life decreased the risk or recurrent wheezing on Y3. While there were no differences in rates of allergen sensitization, pulmonary function tests (FEV0.5 ) were significantly lower in children who developed recurrent wheezing. CONCLUSIONS: In moderate-to-late premature infants, respiratory symptoms were associated with lung morbidity persisted during the first 3 years of life and were associated with abnormal pulmonary function tests. Only anti-RSV prophylaxis exerted a protective effect in the development of recurrent wheezing.
BACKGROUND: Data addressing short- and long-term respiratory morbidity in moderate-late preterm infants are limited. We aim to determine the incidence of recurrent wheezing and associated risk and protective factors in these infants during the first 3 years of life. METHODS: Prospective, multicenter birth cohort study of infants born at 32+0 to 35+0 weeks' gestation and followed for 3 years to assess the incidence of physician-diagnosed recurrent wheezing. Allergen sensitization and pulmonary function were also studied. We used multivariate mixed-effects models to identify risk factors associated with recurrent wheezing. RESULTS: A total of 977 preterm infants were enrolled. Rates of recurrent wheezing during year (Y)1 and Y2 were similar (19%) but decreased to 13.3% in Y3. Related hospitalizations significantly declined from 6.3% in Y1 to 0.75% in Y3. Independent risk factors for recurrent wheezing during Y2 and Y3 included the following: day care attendance, acetaminophen use during pregnancy, and need for mechanical ventilation. Atopic dermatitis on Y2 and male sex on Y3 were also independently associated with recurrent wheezing. Palivizumab prophylaxis for RSV during the first year of life decreased the risk or recurrent wheezing on Y3. While there were no differences in rates of allergen sensitization, pulmonary function tests (FEV0.5 ) were significantly lower in children who developed recurrent wheezing. CONCLUSIONS: In moderate-to-late premature infants, respiratory symptoms were associated with lung morbidity persisted during the first 3 years of life and were associated with abnormal pulmonary function tests. Only anti-RSV prophylaxis exerted a protective effect in the development of recurrent wheezing.
Authors: Cassidy Du Berry; Christopher Nesci; Jeanie L Y Cheong; Tara FitzGerald; Rheanna Mainzer; Sarath Ranganathan; Lex W Doyle; Elianne J L E Vrijlandt; Liam Welsh Journal: EClinicalMedicine Date: 2022-07-29