Predictors of Wheezing in Prematurely Born Children


  • Diane Holditch-Davis,

    Corresponding author
    1. PhD, RN, FAAN, is a Marcus Hobbs Distinguished Professor of Nursing and associate dean for Research Affairs, School of Nursing, Duke University, Durham, NC
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  • Piper Merrill,

    1. MSN, CPNP, PNP, is a pediatric nurse practitioner in the Emergency Department, Children’s Medical Center, Dallas, TX
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  • Todd Schwartz,

    1. DrPH, is a research assistant professor, School of Nursing and the Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill
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  • Mark Scher

    1. MD, is a professor and director of the Division of Pediatric Neurology, Department of Pediatrics, Case Western Reserve University School of Medicine; and Rainbow Babies and Childrens Hospital, Cleveland, OH
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Diane Holditch-Davis, PhD, RN, FAAN, School of Nursing, Duke University, 307 Trent Drive, DUMC 3322, Durham, NC 27710.


Objective:  To examine the degree to which neonatal illness severity, postneonatal health problems, child characteristics, parenting quality as measured by the HOME Inventory, and maternal characteristics are related to the development of wheezing in prematurely born children over the first 27 months after term.

Design:  Longitudinal predictive study.

Setting:  Infants were recruited from two neonatal intensive care units, one in southeast and one in Midwest.

Participants:  One hundred thirteen preterm infants who weighed less than 1,500 g or required mechanical ventilation and their mothers.

Main Outcome Measures:  The presence of wheezing was obtained from maternal report at 2, 6, 9, 13, 18, 22, and 27 months. Wheezing was considered to be medically significant if the child was using bronchodilators or pulmonary antiinflammatory medications.

Results:  Sixty-eight percent of the children had wheezing at least one or more ages; 47% of the children were also taking bronchodilators or pulmonary antiinflammatory medications and thus had medically significant wheezing.

Conclusion:  Postneonatal health problems and the social environment appear to be more important in developing wheezing in prematurely born children than neonatal medical complications.