title: Population-Attributable Risk of Risk Factors for Recurrent Wheezing in Moderate Preterm Infants During the First Year of Life.
abstract: Recurrent wheezing in young infants has a high prevalence, influences quality of life, and generates substantial health care costs. We previously showed that respiratory syncytial virus infection is an important mechanism of recurrent wheezing in moderate preterm infants. We aimed to provide population-attributable risks (PAR) of risk factors for recurrent wheezing during the first year of life in otherwise healthy moderate preterm infants.
  
  
  
  RISK is a multicentre prospective birth cohort study of 4424 moderate preterm infants born at 32-35 weeks gestation. We estimated PAR of risk factors for recurrent wheezing, which was defined as three or more parent-reported wheezing episodes during the first year of life.
  
  
  
  We evaluated 3952 (89%) children at 1 year of age, of whom 705 infants (18%) developed recurrent wheezing. Fourteen variables were independently associated with recurrent wheezing. Hospitalisation for respiratory syncytial virus bronchiolitis had a strong relationship with recurrent wheezing (RR 2.6; 95% confidence interval, CI, 2.2, 3.1), but a relative modest PAR (8%; 95% CI 6, 11%) which can be explained by a low prevalence (13%). Day-care attendance showed a strong relationship with recurrent wheezing (RR 1.9; 95% CI 1.7, 2.2) and the highest PAR (32%; 95% CI 23, 37%) due to a high prevalence (67%). The combined adjusted PAR for the 14 risk factors associated with recurrent wheezing was 49% (95% CI 46, 52%).
  
  
  
  In moderate preterm infants, day-care attendance has the largest PAR for recurrent wheezing. Trial evidence is needed to determine the potential benefit of delayed day-care attendance in this population.
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Maarten O
authors.initials: MO
authors.lastname: Blanken
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Koos
authors.initials: K
authors.lastname: Korsten
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Niek B
authors.initials: NB
authors.lastname: Achten
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Tamminga
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Nibbelke
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Elisabeth A M
authors.initials: EA
authors.lastname: Sanders
authors.affiliation: Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Smit
authors.affiliation: Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Rolf H H
authors.initials: RH
authors.lastname: Groenwold
authors.affiliation: Division of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
mesh_terms: D001988:Bronchiolitis / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000191:economics / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012135:Respiratory Sounds / Q000503:physiopathology*; D018357:Respiratory Syncytial Virus Infections / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: day-care attendance; moderate preterm infants; population-attributable risk; recurrent wheezing; respiratory syncytial virus