Perinatal and Parental Predictors of Wheezing in the First Year of Life: A Saudi Arabian Birth Cohort Study

Background: Infant wheezing is a common respiratory condition with a significant healthcare burden, yet data from the Middle East remain limited. This study aimed to identify predictors of any wheezing and recurrent wheezing during the first year of life in a Saudi Arabian birth cohort. Methods: This retrospective birth cohort study included infants born at King Saud University Medical City, Riyadh, in 2020. Data were collected from electronic medical records and a structured parental questionnaire administered via WhatsApp at 12 months of age, assessing wheezing episodes, parental atopy, household smoking, pets, home humidity, and nearby pollution sources. Any wheezing was defined as ≥1 wheezing episode during the first year, and recurrent wheezing as ≥3 episodes. Variables with p < 0.25 in univariable logistic regression were entered into multivariable models; adjusted odds ratios (aOR) with 95% confidence intervals are reported. Results: Of 594 infants, 135 (22.7%) experienced any wheezing and 85 (14.3%) had recurrent wheezing. NICU admission was independently associated with both any wheezing (aOR 2.65, 95% CI 1.49–4.73; p < 0.001) and recurrent wheezing (aOR 2.34, 95% CI 1.21–4.56; p = 0.012). Parental allergic rhinitis was independently associated with both outcomes (any wheezing: aOR 1.55, 95% CI 1.01–2.37; recurrent wheezing: aOR 1.67, 95% CI 1.00–2.78), while parental eczema was specifically associated with recurrent wheezing (aOR 1.74, 95% CI 1.00–3.03). Conclusions: NICU admission and parental atopy were associated with infant wheezing in this cohort. These findings provide region-specific data from Saudi Arabia but should be regarded as hypothesis-generating and require confirmation in prospective multicentre studies before informing clinical follow-up strategies.