CLINICAL PROFILE AND RISK FACTORS FOR RECURRENT WHEEZING IN CHILDREN UNDER FIVE YEARS OF AGE

Background: Recurrent wheezing is common during the preschool years, but its clinical expression is heterogeneous andthe probability of persistence varies according to host susceptibility, early-life respiratory illness and environmentalexposures. The study is designed to describe the clinical profile of children younger than five years presenting with wheezeand to identify factors associated with recurrent wheezing. Materials and Methods: A hospital-based analytical crosssectionalstudy was designed in the Department of Pediatrics, Apollo Institute of Medical Sciences and Research,Hyderabad, from January 2025 to June 2026. The study included 240 children aged 6–59 months with physician-confirmedwheeze. Recurrent wheeze was defined as three or more physician-confirmed episodes within the preceding 12 months,including the index episode. Clinical history, perinatal factors, atopic features, environmental exposures and bloodeosinophil status were compared between recurrent and non-recurrent groups. Pearson χ² testing, Welch t testing andmultivariable logistic regression were used. Results: Ninety-seven of 240 children (40.4%) met the recurrent-wheezedefinition. Children with recurrent wheeze were older than those with non-recurrent wheeze (29.4±12.6 vs 23.7±12.7months; P<0.001). Family history of asthma/atopy (35.1% vs 20.3%; χ²=6.51, P=0.011), parental smoking (43.3% vs 30.8%;χ²=3.95, P=0.047), prematurity (20.6% vs 11.2%; χ²=4.03, P=0.045), previous bronchiolitis/lower respiratory tract infection(25.8% vs 15.4%; χ²=3.96, P=0.047) and eosinophilia ≥4% (30.9% vs 11.2%; χ²=14.53, P<0.001) were more frequent in therecurrent group. Independent associations were observed for family history, tobacco-smoke exposure, prematurity, previousbronchiolitis and eosinophilia. Conclusion: Recurrent wheezing in preschool children clustered with familial atopy, smokeexposure, prematurity, prior lower respiratory illness and eosinophilia. A structured risk assessment may help identifychildren who warrant closer follow-up and phenotype-directed management.