Risk factors for early wheezing in preterm infants: a retrospective cohort study

Front Pediatr. 2025 Jun 24:13:1555834. doi: 10.3389/fped.2025.1555834. eCollection 2025.

Abstract

Introduction: The related factors that cause recurrent wheezing in children are complex, and premature delivery may be one of the reasons. Little is known about early wheezing in preterm infants.

Methods: Data sourced from 1,616 children born between 2007 and 2013 from 8 hospitals of Guangxi in China. All children were followed by telephone or questionnaire through the sixth year of life. Children were grouped by characters of age: Group A: gestational age (GA ≤ 32 weeks, Group B: 32 weeks < GA < 37 weeks, Group C: 37 weeks ≤ GA < 42 weeks.

Results: The incidence and the risk factors of early wheezing in preterm infants were analyzed. The incidence of early wheezing: Group A > Group B > Group C. In Group A, the proportion of small-for-gestational-age (SGA) infant was higher in early wheezing group than in normal group (P < 0.05). Male (95% CI: 1.611-4.601) and family history of allergy (95% CI: 1.222-3.411) were the risk factors for early wheezing in Group B.

Conclusions: Lower gestational age is associated with higher wheezing risk. Preterm infants have higher persistent wheezing incidence than full-term infants. Preterm infants with gestational age <32 weeks have higher transient wheezing incidence than those with gestational age 32-37 weeks or full-term infants. In preterm infants <32 weeks, small for gestational age (SGA) is a potential factor for wheezing. In preterm infants aged 32-37 weeks, male sex, personal allergy history, and family allergy history are potential factors for wheezing, with male sex and family allergy history being significant risk factors.

Keywords: allergy; gestational age; preterm infants; risk factors; wheezing.