Moderately preterm children have more respiratory problems during their first 5 years of life than children born full term

Am J Respir Crit Care Med. 2013 Jun 1;187(11):1234-40. doi: 10.1164/rccm.201211-2070OC.


Rationale: Pulmonary outcomes of moderate-preterm children (MP) are unknown.

Objectives: To investigate the prevalence of respiratory symptoms during infancy and at preschool age of MP compared with full-term (FT) and early preterm children (EP) and to determine factors associated with respiratory symptoms of MP at school age.

Methods: Prospective cohort study.

Outcome variables: number of rehospitalizations caused by respiratory problems, prevalence of respiratory symptoms determined by ISAAC Questionnaires, and factors associated with respiratory symptoms determined by univariate and multivariate analyzes.

Measurements and main results: A total of 988 MP, 551 EP, and 573 FT children were included. The number of hospitalizations caused by respiratory problems during the first year of life was doubled in MP compared with FT (6% vs. 3%; P < 0.001). At preschool age, compared with FT, MP reported more cough or wheeze during a cold (63% vs. 50%; P < 0.001); cough or wheeze without a cold (23% vs. 15%; P = 0.001); nocturnal cough (33% vs. 26%; P = 0.005); dyspnea (8% vs. 4%; P = 0.011); and use of medication (inhaled steroids, 9% vs. 6%; P = 0.042) (antibiotics, 12% vs. 7%; P = 0.002). Factors associated with respiratory symptoms at 5 years among MP were respiratory problems, eczema, rehospitalization in infancy, passive smoking in infancy, family history of asthma, and higher social class. Multivariate analyzes showed the same results except for rehospitalization in infancy.

Conclusions: MP have more respiratory symptoms than FT during early childhood. Factors associated with respiratory symptoms at school age are early respiratory problems, family history of asthma, higher social class, and passive smoking.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Anti-Bacterial Agents / therapeutic use*
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Netherlands / epidemiology
  • Patient Readmission / trends*
  • Prevalence
  • Prospective Studies
  • Respiratory Care Units / methods*
  • Respiratory Tract Diseases / diagnosis
  • Respiratory Tract Diseases / epidemiology
  • Respiratory Tract Diseases / therapy*
  • Risk Assessment / methods*
  • Severity of Illness Index
  • Surveys and Questionnaires


  • Anti-Bacterial Agents
  • Glucocorticoids

Associated data

  • ISRCTN/ISRCTN80622320