WHEEZING ILLNESS AND RE-HOSPITALIZATION IN THE FIRST TWO YEARS OF LIFE AFTER NEONATAL RESPIRATORY DISTRESS SYNDROME

KOIVISTO, MAILA MD, PHD
MARTTILA, RIITTA MD, PHD
SAARELA, TIMO MD, PHD
POKELA, MARJA-LEENA MD, PHD
VALKAMA, A. MARITA MD, PHD
HALLMAN, MIKKO MD, PHD

Department of Pediatrics, Oulu University Hospital, Oulu, Finland; Department of Pediatrics, Seinäjoki Central Hospital, Seinäjoki, Finland; and Biocenter Oulu, University of Oulu, Oulu, Finland.

Reprint requests: Prof Mikko Hallman, Department of Pediatrics, University of Oulu, PO Box 5000, Fin-90014 University of Oulu, Oulu, Finland. E-mail: [email protected].

Supported by the Foundation for Pediatric Research in Finland.

Submitted for publication Oct 1, 2004; last revision received Dec 14, 2004; accepted Apr 14, 2005.

Journal of Pediatrics 147(4):p 486-492, October 2005.

Objectives

To determine the impact of respiratory distress syndrome (RDS) on wheezing illnesses and re-hospitalizations in children as old as 2 years of age.

Study design

We observed 2 geographically defined cohorts of children with RDS born after 26 weeks of gestation during 1990 to 1995 and 1996 to 1999 and gestationally paired control subjects. Recurrent wheezing illness and the re-hospitalizations caused by a respiratory condition were recorded.

Results

In the first year of life, 47 of 224 infants with RDS and 18 of 224 control subjects born in 1990 to 1995 had recurrent wheezing illness (P < .005) compared with 21 of 109 infants with RDS and 14 of 109 control subjects in the latter cohort (P = .27). A higher number of infants with RDS were readmitted to the hospital (25% versus 13%, P = .002) in the former period, and they spent more days in hospital during both periods. The frequencies of wheezing remained constant in the second year of life, but hospital admissions decreased. Siblings at home, male sex, and bronchopulmonary dysplasia were additional risk factors of wheezing illnesses.

Conclusion

RDS increases the incidence of wheezing illnesses during the first 2 years of life. Changes in the management of RDS during the 1990s was associated with a decreased incidence of subsequent RDS-associated respiratory morbidity.