Respiratory and neurological outcomes in children born preterm study (RANOPs): Preterm outcomes

Introduction Decreased lung function and poor respiratory symptoms are associated with preterm birth in children. Research suggests that preterm birth is associated with increased risk of wheezing disorders in later life. Aims To identify if there was an association between gestational age at birth and respiratory health in childhood. To assess the prevalence of wheezing and the reported diagnosis in children born preterm compared to term controls. Methods A cross sectional survey of all surviving preterm-born children in Wales (N=13361) with matched term-control children was undertaken (N=13361). Children aged 1-10 years old were sent questionnaires (based on ISAAC) to assess respiratory and general health outcomes. Additional data was gathered from national health database. Data was analysed by gestational groups and children <5 or ≥ 5 years of age. Results The <5 years old preterm born children (n=2080), compared to term (n=1380), had higher reported rates of wheezing ever (56% vs 42%, p<0.001), wheeze in the last 3 months (34% vs 19%, p<0.001) and use of inhaled medication (23% vs 12%, p<0.001). This was the same for ≥5 years old preterm born children (n=2068), compared to term controls (n=1456); wheeze ever (43% vs 28%, p<0.001); wheeze over last 12 months (22% vs 15%, p<0.001) and use of inhaled medication (16% vs 11%, p<0.001). Analysis by gestational groups showed a gradient of increasing respiratory symptoms and use of inhaled medication for each week of birth prior to 38 weeks. Conclusion Increasing prematurity was clearly associated with increasing respiratory symptoms and increased treatment for wheezing disorders in childhood.