Growth and respiratory status at 3 years of age after moderate preterm, late preterm and early term births: the Japan Environment and Children's Study

Katsuya Hirata; Kimiko Ueda; Satoyo Ikehara; Kanami Tanigawa; Kazuko Wada; Tadashi Kimura; Keiichi Ozono; Tomotaka Sobue; Hiroyasu Iso; Japan Environment and Children’s Study Group

doi:10.1136/archdischild-2024-327033

Growth and respiratory status at 3 years of age after moderate preterm, late preterm and early term births: the Japan Environment and Children's Study

Arch Dis Child Fetal Neonatal Ed. 2024 Jul 9:fetalneonatal-2024-327033. doi: 10.1136/archdischild-2024-327033. Online ahead of print.

Authors

Katsuya Hirata¹, Kimiko Ueda^{2

3}, Satoyo Ikehara^{3

4}, Kanami Tanigawa^{2

4}, Kazuko Wada⁵, Tadashi Kimura⁶, Keiichi Ozono⁷, Tomotaka Sobue^{3

4}, Hiroyasu Iso^{3

8}; Japan Environment and Children’s Study Group

Collaborators

Japan Environment and Children’s Study Group:
Michihiro Kamijima, Shin Yamazaki, Yukihiro Ohya, Reiko Kishi, Nobuo Yaegashi, Koichi Hashimoto, Chisato Mori, Shuichi Ito, Zentaro Yamagata, Hidekuni Inadera, Takeo Nakayama, Masayuki Shima, Seiji Kageyama, Narufumi Suganuma, Shoichi Ohga, Takahiko Katoh

Affiliations

¹ Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan khirata0513@gmail.com.
² Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
³ Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Osaka, Japan.
⁴ Department of Social and Environmental Medicine, Osaka University, Suita, Osaka, Japan.
⁵ Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
⁶ Department of Obstetrics and Gynecology, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan.
⁷ Pediatrics, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan.
⁸ National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.

PMID: 38981646
DOI: 10.1136/archdischild-2024-327033

Abstract

Objective: To assess the association between gestational age at birth and the risk of growth failure and respiratory symptoms at 3 years of age.

Design: Cohort study using the Japan Environment and Children's Study database.

Patients: A total of 86 158 singleton infants born without physical abnormalities at 32-41 weeks of gestation were enrolled between January 2011 and March 2014.

Main outcome measures: Growth failure (weight <10th percentile and height <10th percentile) and respiratory symptoms (asthma and wheezing) at 3 years of age.

Methods: Logistic regression analysis was used to evaluate the risk of growth failure and respiratory symptoms in the moderately preterm, late preterm and early term groups compared with the full-term group after adjusting for socioeconomic and perinatal factors. Multiple imputation was used to reduce the attrition bias related to missing data.

Results: The respective adjusted ORs (95% CI) of growth failure and respiratory symptoms for the moderate preterm, late preterm and early term groups compared with the full-term group were as follows: weight <10th percentile, 2.29 (1.48-3.54), 1.43 (1.24-1.71) and 1.20 (1.12-1.28); height <10th percentile, 2.34 (1.59-3.45), 1.42 (1.25-1.60) and 1.15 (1.09-1.22); asthma, 1.63 (1.06-2.50), 1.21 (1.04-1.41) and 1.16 (1.09-1.23); and wheezing, 1.39 (1.02-1.90), 1.37 (1.25-1.51) and 1.11 (1.06-1.17).

Conclusion: Moderate preterm, late preterm and early term births were associated with a higher risk of growth failure and respiratory symptoms at 3 years of age than full-term births, with an inverse dose-response pattern.

Keywords: Child Development; Child Health; Epidemiology; Growth; Respiratory Medicine.