title: Exploring modifiable risk factors for wheezing in African American premature infants.
abstract: OBJECTIVE
  To examine the degree to which obesity during infancy, consistent exposure to secondhand smoke, and parenting (positive attention, maternal involvement, and negative control) were related to early development of wheezing in a cohort of African American premature infants at 2, 6, 12, 18, and 24 months corrected age.
  
  
  METHODS
  Secondary analysis of a subset of variables from a larger nursing support intervention study.
  
  
  METHODS
  Two regional perinatal centers in the southeastern United States.
  
  
  METHODS
  One hundred and sixty-eight African American premature infants (70 boys, 98 girls) who weighed less than 1,750 g or required mechanical ventilation and their mothers.
  
  
  METHODS
  The presence of wheezing was obtained from maternal report at 2, 6, 12, 18, and 24 months. Infants were considered to have medically significant wheezing if they were using bronchodilators or pulmonary anti-inflammatory medications.
  
  
  RESULTS
  The percentage of infants who had medically significant wheezing increased from 12% at 2 months to 24% at 24 months corrected age. Infants who received more positive attention from their mothers had a slightly higher increase in the probability of developing wheezing over time. Infants of mothers who received public assistance had an increased probability of wheezing. Consistent exposure to secondhand smoke, obesity during infancy, maternal negative control, and maternal involvement were not related to the development of wheezing.
  
  
  CONCLUSIONS
  These findings suggest that the likelihood of developing wheezing in African American premature infants is associated with receiving more positive attention from their mothers and having mothers who receive public assistance. Because modifiable risk factors were not highly related to wheezing, intervention efforts need to focus on early identification and treatment of wheezing and asthma-related symptoms.
authors.affiliation: School of Nursing, Duke University, Durham, NC 27710, USA.
authors.forename: Jada L
authors.initials: JL
authors.lastname: Brooks
authors.forename: Diane
authors.initials: D
authors.lastname: Holditch-Davis
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.forename: Margaret Shandor
authors.initials: MS
authors.lastname: Miles
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Engelke
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007229:Infant Welfare / Q000208:ethnology*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009034:Mother-Child Relations / Q000208:ethnology*; D016487:Parenting; D012135:Respiratory Sounds / Q000503:physiopathology*; D012307:Risk Factors; D015144:Southeastern United States