title: Chronic lung disease of prematurity and early childhood wheezing: is foetal inflammatory response syndrome to blame?
abstract: BACKGROUND
  Long-lasting respiratory symptoms have a huge impact on the quality of life in prematurely born children.
  
  
  OBJECTIVE
  We aimed to investigate the perinatal and maternal risk factors involved in the development of chronic respiratory morbidity in preterm infants, with an emphasis on the importance of Foetal Inflammatory Response Syndrome (FIRS).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Demographic, antenatal, delivery and outcomes data were collected from 262 infants with less than 32 completed weeks of gestational age, over a 10-year period.
  
  
  METHODS
  Presence of chronic lung disease of prematurity and early childhood wheezing.
  
  
  RESULTS
  In multivariate logistic regression analysis the presence of FIRS appears to be the most important risk factor for both, chronic lung disease of prematurity (OR 31.05, 95% CI 10.7-87.75, p<0.001) and early childhood wheezing (OR 5.63, 95% CI 2.42-13.05, p=0.01). In the alternative regression model for early childhood wheezing, with chronic lung disease included as a variable, the statistical significance of FIRS completely vanished (OR 1.15, 95% CI 0.39-3.34, p=0.79), whilst chronic lung disease became the most important risk factor (OR 23.45, 95% CI 8.5-63.25, p<0.001).
  
  
  CONCLUSIONS
  Prenatal and early neonatal events are of utmost importance in the development of chronic respiratory symptoms in children. The influence of FIRS on the development of chronic respiratory symptoms goes far beyond its impact on gestational age and may be related to direct inflammation-mediated lung tissue damage. CLD appears to be an intermittent step on the way from FIRS to ECW.
authors: Department of Pediatrics, University Hospital Center Rijeka, Croatia. Electronic address: sindin2@net.hr.
authors: Nada Sindičić
authors: NS
authors: Dessardo
authors: Department of Pediatrics, University Hospital Center Rijeka, Croatia. Electronic address: sandro.dessardo@covidien.com.
authors: Sandro
authors: S
authors: Dessardo
authors: Institute of Pathology, University of Rijeka, Croatia. Electronic address: mustace@med.hr.
authors: Elvira
authors: E
authors: Mustać
authors: Department of Pediatrics, University of Rijeka, Croatia. Electronic address: srdan.banac@medri.uniri.hr.
authors: Srđan
authors: S
authors: Banac
authors: Institute of Perinatology, Department of Gynecology and Obstetrics, University Hospital Center Rijeka, Croatia. Electronic address: oleg@kbc-rijeka.hr.
authors: Oleg
authors: O
authors: Petrović
authors: Institute of Neonatology, Department of Gynecology and Obstetrics, University Hospital Center Rijeka, Croatia. Electronic address: branimir.peter@gmail.com.
authors: Branimir
authors: B
authors: Peter
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D005315:Fetal Diseases / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007249:Inflammation / Q000150:complications*; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D012135:Respiratory Sounds
keywords: Chorioamnionitis; Chronic lung disease; Early childhood wheezing; FIRS; Prematurity