Respiratory morbidities in preterm neonates during the first year of life: A prospective observational study

Background: Infants born preterm develop numerous short- and long-term respiratory morbidities. However, there are scanty data available from India. Aims: The study was conducted to determine the incidence of hospitalization due to respiratory morbidities during the 1st year of life in preterm neonates (<37 completed weeks). The secondary aim was to determine the impact of respiratory morbidity on growth and need for nebulization. Patients and Methods: This prospective study was conducted in a level III neonatal intensive care unit. Data regarding maternal and neonatal history and examination were collected in the study proforma. Follow-up was done at predetermined intervals, and details of subsequent outpatient and inpatient treatments were recorded. Statistical analysis - Chi-square test/Fisher's exact test, unpaired t-test, and multivariate logistic regression were used for statistical analysis. P < 0.05 was considered as statistically significant. Results: Three hundred and forty-four infants (192 - male and 121 - inborn) were included. Fifty-eight (16.8%) infants were readmitted - 84% bronchiolitis, 12% pneumonia, and 27.5% as wheeze-associated lower respiratory tract infection. On multivariate analysis, growth status at birth, presence of hemodynamically significant patent ductus arteriosus (PDA), lower socioeconomic status (SES), and lack of exclusive breastfeeding were associated with risk of readmission. 12.2% (42/344) of the admitted preterm neonates needed nebulization with bronchodilators during follow-up. Growth was hampered in those requiring readmissions. Conclusion: 16.8% of the preterm neonates were admitted for respiratory morbidities at 1-year follow-up. Small for gestational age, presence of hemodynamically significant PDA needing medical closure, lack of exclusive breastfeeding for 6 months, and lower SES were risk factors for respiratory morbidity in infancy.