title: Risk factors for bronchiolitis, recurrent wheezing, and related hospitalization in preterm infants during the first year of life.
abstract: BACKGROUND
  Airway diseases are highly prevalent in infants and cause significant morbidity. We aimed to determine the incidence and risk factors for respiratory morbidity in a Spanish cohort of moderate-to-late preterm (MLP) infants prospectively followed during their first year of life.
  
  
  METHODS
  SAREPREM is a multicenter, prospective, longitudinal study. Preterm infants born at 32-35 weeks of gestation with no comorbidities were enrolled within 2 weeks of life and followed at 2-4 weeks, 6, and 12 months of age. Multivariate mixed-models were performed to identify independent risk factors associated with (i) development of bronchiolitis, (ii) recurrent wheezing, or (iii) related hospital admissions.
  
  
  RESULTS
  Overall, 977 preterm infants were included, and 766 (78.4%) completed follow-up. Of those, 365 (47.7%) developed bronchiolitis during the first year, 144 (18.8%) recurrent wheezing, and 48 (6.3%) were hospitalized. While low birthweight, day care attendance (DCA) and school-age siblings were significantly and independently associated with both the development of bronchiolitis and recurrent wheezing, lower maternal age increased the risk for bronchiolitis and respiratory-related hospitalizations. Lastly, mechanical ventilation was associated with a higher risk of bronchiolitis and history of asthma in any parent increased the likelihood of developing recurrent wheezing.
  
  
  CONCLUSIONS
  In this study, several non-modifiable parameters (family history of asthma, low birthweight, need for mechanical ventilation) and modifiable parameters (young maternal age, DCA, or exposure to school-age siblings) were identified as significant risk factors for the development of bronchiolitis and recurrent wheezing during the first year of life in MLP infants.
authors.affiliation: Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia-Instituto Biodonostia, San Sebastián, Spain.|Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.|Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain.
authors.forename: Eduardo G
authors.initials: EG
authors.lastname: Pérez-Yarza
authors.affiliation: Pediatric Pulmonary Unit, Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moreno-Galdó
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
authors.forename: Octavio
authors.initials: O
authors.lastname: Ramilo
authors.affiliation: Pediatric Pulmonary Section, Hospital Torrecárdenas, Almería, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rubí
authors.affiliation: Pediatric Pulmonary Unit, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Escribano
authors.affiliation: Department of Pediatrics, Hospital San Juan de la Cruz, Úbeda, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.affiliation: Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia-Instituto Biodonostia, San Sebastián, Spain.|Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain.
authors.forename: Olaia
authors.initials: O
authors.lastname: Sardón
authors.affiliation: Pediatric Pulmonary Unit, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Oliva
authors.affiliation: Pediatric Pulmonary Section, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Pérez
authors.affiliation: Pediatric Pulmonary Section, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Cortell
authors.affiliation: Pediatric Pulmonary Unit, Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rovira-Amigo
authors.affiliation: Pediatric Pulmonary Section, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Pastor-Vivero
authors.affiliation: Pediatric Pulmonary Unit, Hospital Materno-Infantil, Málaga, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez-Frías
authors.affiliation: Pediatric Pulmonary Unit, Hospital Clínico Universitario, Tenerife, Spain.
authors.forename: Valle
authors.initials: V
authors.lastname: Velasco
authors.affiliation: Pediatric Pulmonary and Allergy Unit, Hospital Reina Sofía, Córdoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Torres-Borrego
authors.affiliation: Pediatric Pulmonary Section, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Figuerola
authors.affiliation: Pediatric Pulmonary Section, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Barrio
authors.affiliation: Pediatric Pulmonary and Allergy Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: García-Hernández
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
authors.forename: Asunción
authors.initials: A
authors.lastname: Mejías
mesh_terms: D001988:Bronchiolitis / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors; D013030:Spain
keywords: bronchiolitis; bronchitis; premature birth; risk factors; wheezing