A Cross-sectional Study of the Prevalence, Clinical Profile, and Risk Factors of Wheezing in Under-5 Children Hospitalized at a Tertiary Care Teaching Hospital of Anand District, Gujarat

Abstract Background: Wheezing is a common and clinically significant presentation among children under 5 years of age, contributing substantially to pediatric hospital admissions. The pathophysiology is multifactorial, involving immature respiratory anatomy, viral infections, environmental exposures, and genetic predisposition. Early identification of key risk factors and recognition of common presentation patterns are crucial for timely intervention, better outpatient management, and prevention of recurrent hospitalizations. Objectives: To estimate the prevalence of hospitalized wheezing cases in children under 5 years of age and to evaluate their clinical profiles and associated risk factors. Materials and Methods: This hospital-based cross-sectional study was conducted over 12 months (February 2024–January 2025) in the Department of Pediatrics at a tertiary care teaching hospital. A total of 97 children aged 1 month to 5 years, admitted with wheezing, were included using consecutive sampling. Data were collected using a structured questionnaire that encompassed demographic characteristics, environmental exposures (such as tobacco smoke and pets), clinical history, perinatal factors, and previous treatments. Descriptive statistics were used to summarize categorical variables in terms of frequencies and percentages. Continuous variables were expressed as medians. Associations between key clinical characteristics and risk factors were explored using the chi-square test or Fisher’s exact test as appropriate. A P value of less than 0.05 was considered statistically significant. Results: Out of 1220 total pediatric admissions during the study period, 97 (7.95%) were admitted with wheezing. Among them, 59 (60.82%) were male, with a male-to-female ratio of 1.5:1. Out of 97, 43 (44.32%) were aged 2–12 months. Notably, 79 (81.44%) of the children were from rural areas, and 53 (54.63%) of fathers were laborers. Preterm birth was recorded in 12 (12.37%) children, and 16 (16.5%) required neonatal intensive care unit admission at birth. Exclusive breastfeeding was reported in 84 (86.6%) cases, while 13 (13.4%) received alternative feeding, primarily formula feeds. Out of 97, 46 (47.42%) had a similar history of wheezing in the past, but only 31 (31.95%) had received salbutamol. Of these, nebulization was the most common route (32, 32.98%), followed by MDI with spacer (6, 6.18%). Only two (2.06%) children had a prior diagnosis of asthma. Environmental exposures included paternal smoking in six (6.18%) cases and pet ownership in nine (9.27%). Despite high exclusive breastfeeding rates, recurrent admissions were common, with 77 (79.38%) children having been previously hospitalized and 49 (50.5%) having subsequent admissions within the study period. Statistical analysis revealed significant associations between rural residence and higher hospitalization rates ( P < 0.05), while no significant association was found between exclusive breastfeeding and reduced wheezing episodes. Conclusion: This study highlights the high burden of wheezing-related hospitalizations in children under 5, particularly among rural and socioeconomically disadvantaged populations. Although exclusive breastfeeding was prevalent, it did not significantly reduce wheezing episodes, and so multifactorial influences. The low prior use of bronchodilators and inhalers suggests a gap in early outpatient care and awareness.