Open-access The impact of neonatal respiratory distress syndrome on subsequent preschool wheezing in very preterm infants: a multicenter cohort study

Background  This multicenter cohort study investigated the association between neonatal Respiratory Distress Syndrome (RDS) and wheezing in preschool-aged preterm infants.

Methods  A total of 525 children born at < 32-weeks’ gestation were enrolled from three tertiary hospitals in Southwest China and classified into RDS (n = 275) and non-RDS (n = 250) groups. Current wheezing (≥ 1 parental-reported episode in the past year) outcomes were assessed using the International Study on Asthma and Allergy in Childhood (ISAAC) questionnaire at 3-6 years of age.

Results  The RDS group showed a significantly higher incidence of current wheezing (11.3% vs. 5.6%; aOR = 2.45, 95% CI 1.20-4.98). Subgroup analyses revealed particularly elevated risks among females, infants born at 28⁺⁰-29⁺⁶ weeks, those with birth weights of 1000-1499g, non-IVF conceptions, those with bronchopulmonary dysplasia, and those with < 14-days of oxygen therapy. Sensitivity analyses supported the robustness of these findings.

Conclusions  The study indicates that RDS is an independent risk factor for wheezing in preterm preschoolers and highlights the need for targeted respiratory monitoring in this population.

Keywords
Respiratory distress syndrome; Wheezing; Very preterm infants; Preschool children; Cohort study

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