565
Born preterm
Children born prematurely across a range of gestational ages and respiratory outcomes.
The RHiNO Study
From early-life respiratory risk to lifelong lung health
Respiratory Health Outcomes in Neonates (RHiNO) was established to understand why some children born preterm develop respiratory symptoms and reduced lung function, how these abnormalities can be characterised, and whether they can be treated.
Original recruitment and study visits were completed in November 2019.
The RHiNO programme continues through analysis, publication and longitudinal follow-up.
What was RHiNO?
A detailed childhood study of respiratory health after preterm birth
RHiNO studied children aged 7–12 years to determine why children born preterm have more respiratory symptoms and lower lung-function measurements than children born at term. The programme combined population screening with detailed physiological assessment, a randomised inhaler trial and advanced lung imaging.
1,122screening questionnaires returned
767children underwent RHiNO assessment
565children were born preterm
202term-born comparison participants
How RHiNO developed
From population research to deep phenotyping
2012 onward
RANOPs and population studies
Earlier Welsh studies used large-scale questionnaires to investigate respiratory and neurodevelopmental outcomes after preterm birth. Approximately 26,000 questionnaires were sent and around 7,000 responses created the population foundation for subsequent RHiNO research.
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2016
RHiNO begins
Families were invited into a more detailed programme combining symptoms, spirometry, bronchodilator response and subsequent specialist physiological assessment.
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Today
Life-course PLD research
RHiNO has evolved into a programme studying prematurity-associated lung disease, its physiological phenotypes, mechanisms, treatment responses and trajectories towards adulthood.
Who took part?
A deeply characterised cohort of preterm-born and term-born children
RHiNO deliberately included children born preterm with a range of later respiratory outcomes, together with term-born comparison participants. This allowed the programme to separate the effects of preterm birth from the physiological patterns found later in childhood.
202
Born at term
Comparison participants studied using the same core respiratory assessments.
53
Randomised inhaler trial
Preterm-born children with reduced lung function entered the three-month treatment trial.
65
Advanced MRI
Children travelled to Sheffield for specialist hyperpolarised-gas lung MRI.
What did participants do?
A staged programme of increasingly detailed respiratory assessment
Questionnaires
Respiratory symptoms, health history and relevant early-life information.
Spirometry
Standardised measurement of expiratory airflow and response to bronchodilator.
Detailed physiology
Further lung-function testing, exercise assessment and detailed respiratory phenotyping.
Treatment trial
A three-month randomised trial of inhaled therapies used commonly in asthma.
Advanced MRI
Specialist radiation-free hyperpolarised-gas imaging to examine regional lung structure and function.
The study pathway
From invitation to discovery
1ScreeningQuestionnaire and initial respiratory assessment
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2Home / research visitSpirometry and bronchodilator testing
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3Deep phenotypingDetailed physiology in Cardiff
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4Intervention / MRIInhaler trial and specialist imaging
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5Analysis & follow-upPhenotypes, mechanisms and trajectories
The RHiNO timeline
How the programme has evolved
2012 onward
Population studies
Large-scale questionnaire research establishes persistent respiratory effects after preterm birth.
Autumn 2016
RHiNO begins
Childhood respiratory assessments start across Wales.
2016–2019
Screening and deep phenotyping
Spirometry, bronchodilator testing and detailed physiology characterise later respiratory impairment.
2017–2019
Inhaler trial and MRI
Selected children enter the treatment trial and 65 undergo advanced lung MRI.
November 2019
Original study visits complete
The programme shifts from recruitment to analysis, publication and follow-up.
2022
Randomised trial published
Combined ICS/LABA improves lung function in selected preterm-born children with reduced FEV₁.
2022–2025
PLD, imaging and mechanisms
Phenotyping, MRI, pollution, metabolomics and respiratory-mechanics studies expand the programme.
January 2026
PLD Series
The Lancet Respiratory Medicine Series integrates PLD phenotypes, trajectories and management.
Now
Longitudinal research
RHiNO is studying how lung function and PLD phenotypes evolve through adolescence towards adulthood.
After recruitment
The value of the cohort continues to grow
Completion of the original study visits did not mark the end of RHiNO. The cohort has continued to generate new knowledge on PLD phenotypes, inhaled treatment, exercise, advanced imaging, air pollution, metabolomics and respiratory mechanics.
The next phase is increasingly longitudinal: understanding which physiological abnormalities persist, which change as lungs grow, and which may be modified to improve future respiratory health.
Historical study archive
Original participant information remains available
Recruitment is complete, but the original parent and child information sheets, consent/assent materials, questionnaires and descriptions of study visits remain an important record of how RHiNO was conducted.
Participants & families
Historical information about visits, breathing tests, exercise testing and MRI.
View participant archive →Research & publications
Explore the scientific outputs generated from the RHiNO programme.
Browse publications →Our discoveries
See the major findings explained in accessible language.
Explore discoveries →Our preterm lung research programme
Following respiratory health from birth to later life
Birth • neonatal care
AZTEC
Azithromycin Therapy for Chronic Lung Disease of Prematurity
Visit AZTEC ↗→
Discharge • infancy
BALLOON Trial
Preventing respiratory infections after discharge
Visit BALLOON ↗→
Childhood • adolescence • beyond
RHiNO
Respiratory Health Outcomes in Neonates
RHiNO home →