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J Allergy Clin Immunol. 2015 Sep;136(3):581-587.e2. doi: 10.1016/j.jaci.2015.05.005. Epub 2015 Jun 24.

Early-term birth is a risk factor for wheezing in childhood: A cross-sectional population study.

Author information

1
Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
2
NHS Wales Informatics Service, Cardiff, United Kingdom.
3
Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom. Electronic address: kotechas@cardiff.ac.uk.

Abstract

BACKGROUND:

Early term-born (37-38 weeks' gestation) infants have increased respiratory morbidity during the neonatal period compared with full term-born (39-42 weeks' gestation) infants, but longer-term respiratory morbidity remains unclear.

OBJECTIVE:

We assessed whether early term-born children have greater respiratory symptoms and health care use in childhood compared with full term-born children.

METHODS:

We surveyed 1- to 10-year-old term-born children (n = 13,361). Questionnaires assessed respiratory outcomes with additional data gathered from national health databases.

RESULTS:

Of 2,845 eligible participants, 545 were early term-born and 2,300 were full term-born. Early term-born children had higher rates of admission to the neonatal unit (odds ratio [OR], 1.7; 95% CI, 1.2-2.5) and admission to the hospital during their first year of life (OR, 1.6; 95% CI, 1.2-2.1). Forty-eight percent of early term-born children less than 5 years old reported wheeze ever compared with 39% of full term-born children (OR, 1.5; 95% CI, 1.1-1.9), and 26% versus 17% reported recent wheezing (OR, 1.7; 95% CI, 1.3-2.4). Early term-born children older than 5 years reported higher rates of wheeze ever (OR, 1.4; 95% CI, 1.05-1.8) and recent wheezing over the last 12 months than full-term control subjects (OR, 1.4; 95% CI, 1.02-2.0). Increased rates of respiratory symptoms in early term-born children persisted when family history of atopy and delivery by means of cesarean sections were included in logistic regression models.

CONCLUSION:

Early term-born children had significantly increased respiratory morbidity and use of health care services when compared with full term-born children, even when stratified by mode of delivery and family history of atopy.

KEYWORDS:

Cesarean section; asthma; atopy; bronchodilators; gestational age; wheezing

PMID:
26115906
DOI:
10.1016/j.jaci.2015.05.005
[Indexed for MEDLINE]

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