title: Early-term birth is a risk factor for wheezing in childhood: A cross-sectional population study.
abstract: BACKGROUND
  Early term-born (37-38 weeks' gestation) infants have increased respiratory morbidity during the neonatal period compared with full term-born (39-42 weeks' gestation) infants, but longer-term respiratory morbidity remains unclear.
  
  
  OBJECTIVE
  We assessed whether early term-born children have greater respiratory symptoms and health care use in childhood compared with full term-born children.
  
  
  METHODS
  We surveyed 1- to 10-year-old term-born children (n = 13,361). Questionnaires assessed respiratory outcomes with additional data gathered from national health databases.
  
  
  RESULTS
  Of 2,845 eligible participants, 545 were early term-born and 2,300 were full term-born. Early term-born children had higher rates of admission to the neonatal unit (odds ratio [OR], 1.7; 95% CI, 1.2-2.5) and admission to the hospital during their first year of life (OR, 1.6; 95% CI, 1.2-2.1). Forty-eight percent of early term-born children less than 5 years old reported wheeze ever compared with 39% of full term-born children (OR, 1.5; 95% CI, 1.1-1.9), and 26% versus 17% reported recent wheezing (OR, 1.7; 95% CI, 1.3-2.4). Early term-born children older than 5 years reported higher rates of wheeze ever (OR, 1.4; 95% CI, 1.05-1.8) and recent wheezing over the last 12 months than full-term control subjects (OR, 1.4; 95% CI, 1.02-2.0). Increased rates of respiratory symptoms in early term-born children persisted when family history of atopy and delivery by means of cesarean sections were included in logistic regression models.
  
  
  CONCLUSIONS
  Early term-born children had significantly increased respiratory morbidity and use of health care services when compared with full term-born children, even when stratified by mode of delivery and family history of atopy.
authors.affiliation: Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Edwards
authors.affiliation: Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Kotecha
authors.affiliation: Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Lowe
authors.affiliation: NHS Wales Informatics Service, Cardiff, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Richards
authors.affiliation: Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom.
authors.forename: W John
authors.initials: WJ
authors.lastname: Watkins
authors.affiliation: Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom. Electronic address: kotechas@cardiff.ac.uk.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kotecha
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000503:physiopathology; D012307:Risk Factors; D047929:Term Birth
keywords: Cesarean section; asthma; atopy; bronchodilators; gestational age; wheezing