Abstract
Objective
This study describes the burden of prematurity-associated wheezing in black infants with respect to caregiver missed work.
Study design
We analyzed data from the D-Wheeze trial (ClinicalTrials.gov identifier NCT01601847). Black infants between 28–0/7 to 36–6/7 weeks’ gestational age at birth receiving <28 days of supplemental oxygen were enrolled. The primary outcome was missed work to care for the infant in the first year.
Results
147/277 (53.1%) infants had caregivers who reported time off. In an adjusted model, vitamin D supplementation (OR 0.52 [95% CI 0.30–0.89]; P = 0.018), recurrent wheeze (OR 2.26 [95% CI, 1.15–4.44]; P = 0.018), and other children in the household <5 years old (OR 0.45 [95% CI 0.26–0.78]; P = 0.004) were significantly associated with caregiver missed work.
Conclusions
Black premature infants had a significant burden of caregiver missed work, emphasizing the impact of prematurity-associated wheezing.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Been JV, Lugtenberg MJ, Smets E, van Schayck CP, Kramer BW, Mommers M, et al. Preterm birth and childhood wheezing disorders: a systematic review and meta-analysis. PLOS Med. 2014; e1001596. https://doi.org/10.1371/journal.pmed.1001596.
Priante E, Moschino L, Mardegan V, Manzoni P, Salvadori S, Baraldi E. Respiratory outcome after preterm birth: a long and difficult journey. Am J Perinatol. 2016;33:1040–2.
Schwartz J, Gold D, Dockery DW, Weiss ST, Speizer FE. Predictors of asthma and persistent wheeze in a national sample of children in the united states: association with social class, perinatal events, and race. Am Rev Respir Dis. 1990;142:555–62.
Underwood MA, Danielsen B, Gilbert WM. Costs, causes and rates of rehospitalization of preterm infants. J Perinatol. 2007;27:614–9.
Rietveld E, de Jonge HC, Polder JJ, Vergouwe Y, Veeze HJ, Moll HA, et al. Anticipated costs of hospitalization for respiratory syncytial virus infection in young children at risk. Pediatr Infect Dis J. 2004;23:523–9.
Chirikov VV, Simões EAF, Kuznik A, Kwon Y, Botteman M. Economic burden trajectories in commercially insured us infants with respiratory syncytial virus. J Infect Dis. 2019. https://doi.org/10.1093/infdis/jiz160.
Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med. 1992;326:862–6.
Neuzil KM, Hohlbein C, Zhu Y. Illness among schoolchildren during influenza season: effect on school absenteeism, parental absenteeism from work, and secondary illness in families. Arch Pediatr Adolesc Med. 2002;156:986–91.
Petruzella FD, Gorelick MH. Duration of illness in infants with bronchiolitis evaluated in the emergency department. Pediatrics. 2009;126:e285–e290.
Hibbs AM, Ross K, Kerns LA, Wagner C, Fuloria M, Groh-Wargo S, et al. Effect of vitamin D supplementation on recurrent wheezing in black infants who were born preterm: the D-Wheeze randomized clinical trial. JAMA. 2018;319:2086–94.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483–91.
Boggs E, Minich N, Hibbs AM. Performance of commonly used respiratory questionnaire items in a cohort of infants born preterm. Open J Pediatr. 2013;3:260–5.
Gaskin DJ, Arbelaez JJ, Brown JR, Petras H, Wagner FA, Cooper LA. Examining racial and ethnic disparities in site of usual source of care. J Natl Med Assoc. 2007;99:22–30.
Jenkins M, Clarke JR, Carlin JB, Robertson CF, Hopper JL, Dalton MF, et al. Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma. Int J Epidemiol. 1996;25:609–16.
Vrijlandt EJL, Kerstjens JM, Duiverman EJ, Bos AF, Reijneveld SA. Moderately preterm children have more respiratory problems during their first 5 years of life than children born full term. Am J Respir Crit Care Med. 2013;187:1234–40.
Leader S, Yang H, DeVincenzo J, Jacobson P, Marcin JP, Murray DL. Time and out-of-pocket costs associated with respiratory syncytial virus hospitalization of infants. Value Health. 2003;6:100–6.
Hodek JM, von der Schulenburg JM, Mittendorf T. Measuring economic consequences of preterm birth—methodological recommendations for the evaluation of personal burden on children and their caregivers. Health Econ Rev. 2011;1:6.
Nurmagambetov T, Kuwahara R, Garbe P. The economic burden of asthma in the United States, 2008-13. Ann Am Thorac Soc. 2018;15:348–56.
Chung P, Garfield CF, Elliott MN, Vestal KD, Klein D, Schuster M. Double bind: primary caregivers of children with special health care needs and their access to leave benefits. Acad Pediatr. 2013;13:222–8.
Jacobs JC, Van Houtven CH, Tanielian T, Ramchand R. Economic spillover effects of intensive unpaid caregiving. PharmacoEconomics. 2019;37:553–62.
Acknowledgements
This research was supported by National Heart, Lung, and Blood Institute (NHLBI) and Office of Dietary Supplement of the National Institutes of Health (R01HL109293) and by the NHLBI (K24HL143291). We thank Rainbow Babies and Children’s Hospital in Cleveland, OH for providing administrative and research assistance for this study. We thank the participants of the D-Wheeze trial for their contributions to the trial.
Funding
This study was funded by the NHLBI and ODS (R01HL109293) and by the 327 NHLBI (K24HL143291).
Author information
Authors and Affiliations
Contributions
LL conceptualized and designed the study, helped to interpret the data, drafted the initial manuscript, and reviewed and revised the manuscript. NM and CT had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. They provided statistical analyses and data interpretation and reviewed and revised the manuscript for important intellectual content. KRR participated in the concept, design and data acquisition of the original trial from which these data were obtained, data interpretation, and review and revision of the manuscript. LAK participated in data acquisition of the original trial from which these data were obtained, data interpretation, and review and revision of the manuscript. CLW participated in data acquisition of the original trial from which these data were obtained, data interpretation, and review and revision of the manuscript. MF participated in data acquisition of the original trial from which these data were obtained, data interpretation, and review and revision of the manuscript. SG-W participated in data acquisition of the original trial from which these data were obtained, data interpretation and review and revision of the manuscript. TZ participated in the concept and design of the original trial from which these data were obtained and review and revision of the manuscript. AMH had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. She conceptualized and designed the study, coordinated and supervised data collection, helped to interpret the data, reviewed and revised the manuscript, and obtained funding for this study. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Corresponding author
Ethics declarations
Conflict of interest
AMH and TZ reported receiving grants from the National Heart, Lung, and Blood Institute (NHLBI) and Office of Dietary Supplements (ODS). KRR reported receiving grants and/or nonfinancial support from the National Institutes of Health, ODS, Boehringer Ingelheim, Teva, GlaxoSmithKline, Merck, Flamel, and Jazz Pharmaceuticals, and Otsuka Pharma/Pharmavite. CLW reported receiving grants and/or personal fees from the National Institutes of Health/NHLBI and Church & Dwight Inc, for which she served as a scientific consultant. SG-W reported receiving speaker honoraria from Abbott Nutrition. CT reported receiving grants from the National Institutes of Health, ODS, National Science Foundation, and Biogen. MF reported receiving grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD092533). LL and NM declare no potential conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ledingham, L., Tatsuoka, C., Minich, N. et al. Burden of prematurity-associated recurrent wheezing: caregiver missed work in the D-Wheeze trial. J Perinatol 41, 69–76 (2021). https://doi.org/10.1038/s41372-020-0729-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41372-020-0729-7