Incidence and risk factors of hospitalization for bronchiolitis in preterm children: a retrospective longitudinal study in Italy

Pezzotti, Patrizio; Mantovani, Jessica; Benincori, Nicoletta; Mucchino, Eleonora; Lallo, Domenico Di

doi:10.1186/1471-2431-9-56

Cited by 26 publications

(36 citation statements)

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“…The increased risk of respiratory hospital admissions in infants born in the summer months is consistent with known risk factors of hospitalization for bronchioloitis. 27 We also found a protective effect associated with breastfeeding, consistent with other studies. 4,28 Despite high levels of breastfeeding initiation in the United Kingdom (81%), only 22% of mothers continue to breastfeed at 6 months.…”

Section: Discussionsupporting

confidence: 92%

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

et al. 2013

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OBJECTIVE: To investigate the risk of emergency respiratory hospital admission during childhood associated with gestational age at birth and growth restriction in utero. METHODS: The study included a total population electronic birth cohort with anonymized record-linkage of multiple health and administrative data sets. Participants were 318 613 children born in Wales, United Kingdom, between May 1, 1998, and December 31, 2008. The main outcome measure was emergency respiratory hospital admissions. RESULTS: The rate of admission in the first year of life ranged from 41.5 per 100 child-years for infants born before 33 weeks’ gestation to 9.8 per 100 child-years for infants born at 40 to 42 weeks’ gestation. The risk of any emergency respiratory admission up to age 5 years increased as gestational age decreased to <40 weeks. Even at 39 weeks’ gestation, there was an increased risk of emergency hospital admissions for respiratory conditions compared with infants born at 40 to 42 weeks (adjusted hazard ratio 1.10; 95% confidence interval 1.08–1.13). Small for gestational age (<10th centile for gestation and gender-specific birth weight) was independently associated with an increased risk of any emergency respiratory admission to hospital (adjusted hazard ratio 1.07; 95% confidence interval 1.04–1.10). CONCLUSIONS: The risk of emergency respiratory admission up to age 5 years decreased with each successive week in gestation up to 40 to 42 weeks. Although the magnitude of increased risk associated with moderate and late preterm births is small, the number of infants affected is large and therefore presents a significant impact on health care services.

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Section: Discussionsupporting

confidence: 92%

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

et al. 2013

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“…Cardiac diagnoses included only if established at 1 of the 3 centres for pediatric cardiology107.0NR1.70 (1.45–1.99)Kristensen 2009 [38]Denmark7-year retrospective, multicenter study (1996–2003) of 3239 children <2 years with heart disease; no child received RSV immunoprophylaxisCategorized as HS-CHD in all patients who were cyanotic, decompensated or required anti-congestive therapy. In other patients hemodynamic significance categorized as determined by the attending pediatric cardiologistCHD/HS-CHD: 102.00–5 months: 71.3 a,b 6–11 months: 73.2 a,b 12–17 months: 43.4 a,b 18–23 months: 29.6 a,b 0–23 months: 56.5 a,b NAHS-CHD: 1.53 (1.04–2.26) c Cardiomyopathy: 5.84 (1.26–27.16) c Medrano López 2010 [5]Spain4-year prospective, multicenter study (2004–2008) of 2613 children <2 years with HS-CHD hospitalized for ARI (3.8% diagnosed RSV); 90.5% received RSV prophylaxisDefinition of HS-CHD stipulated by the Spanish Society of Pediatric CardiologyHS-CHD: 38.0NRNRErikkson 2002 [40]Sweden12-year retrospective study (1987–1998) of 1503 episodes of RSVH in children <2 years; infants with cardiac malformation (2.9% catchment area; 13% from other areas); no data on RSV immunoprophylaxisCardiac malformation/lesion—not definedCHD: 28.0–64.0 d NRNRSimoes 1998 [44]US3-year prospective, multicenter, randomized, controlled study of 416 children <4 years with CHD or cardiomyopathy (214 control group—no RSV immunoprophylaxis)Not definedCHD: 150.0 (control group)<6 months: 240.0 (control group)>6 months: 90.0 (control group)NRNR RSVH rates for studies with mixed populations of infants and children Lanari 2004 [45]Italy6-month retrospective study (1999–2000) of 1214 children <2 years hospitalized for LRTI or developed RSV LRTI whilst hospitalized in 32 tertiary centers (3.5% non-surgically corrected CHD)Not definedCHD: 357.0Nosocomially acquired RSV: 98.0NRNRPezzotti 2009 [43]Italy6-year retrospective cohort study (2000–2006) o...…”

Section: Resultsmentioning

confidence: 99%

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

et al. 2017

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IntroductionThe REGAL (RSV Evidence—a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This fourth publication covers the risk and burden of RSV infection in infants with congenital heart disease (CHD).MethodsA systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015 across PubMed, Embase, The Cochrane Library, and Clinicaltrials.gov. Studies reporting data for hospital visits/admissions for RSV infection among children with CHD as well as studies reporting RSV-associated morbidity, mortality, and healthcare costs were included. The focus was on children not receiving RSV prophylaxis. Study quality and strength of evidence (SOE) were graded using recognized criteria.ResultsA total of 1325 studies were identified of which 38 were included. CHD, in particular hemodynamically significant CHD, is an independent predictor for RSV hospitalization (RSVH) (high SOE). RSVH rates were generally high in young children (<4 years) with CHD (various classifications), varying between 14 and 357/1000 (high SOE). Children (<6 years) with RSV infection spent 4.4–14 days in hospital, with up to 53% requiring intensive care (high SOE). Infants (<2 years) with CHD had a more severe course of RSVH than those without CHD (high SOE). Case fatality rates of up to 3% were associated with RSV infection in children with CHD (high SOE). RSV infection in the perioperative period of corrective surgery and nosocomial RSV infection in intensive care units also represent important causes of morbidity (moderate SOE).ConclusionCHD poses a significant risk for RSVH and subsequent morbidity and mortality. RSV infection often complicates corrective heart surgery. To reduce the burden and improve outcomes, further research and specific studies are needed to determine the longer-term effects of severe RSV infection in young children with CHD.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0142-x) contains supplementary material, which is available to authorized users.

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“…In a prospective, population-based study of RSVH in premature and term infants by Hall et al [4], infants ≤2 months accounted for an important proportion of all children admitted with RSV infection in the first 2 years of life: 11% were infants <1 month old, 44% were ≤2 months old, and only 36% were >5 months old. In a retrospective longitudinal study of 2407 preterm infants in Italy, the incidence of RSVH declined with age [59]. In this study, significantly higher incidence rates were observed in the first 6 months of life and incidence rates significantly decreased with age ( P < 0.01), from 89.3/1000 person-years for infants aged 0–6 months to 7.6/1000 person-years for infants aged 12–18 months.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence rates also varied significantly by month of age ( P < 0.01) and by calendar month ( P < 0.01). After 18 months of age, however, RSVH was rare [59]. A recent retrospective analysis from the Osservatorio Study in Italy [60], which enrolled three different gestational age group infants (<29, 29 to <32 and 32–35 wGA), found that the percentage of hospitalized preterm infants ≤12 months old that were RSV positive progressively decreased from 40.0% to 28.6% and 18.4% with increasing wGA ( P = 0.43).…”

Section: Resultsmentioning

confidence: 99%

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

Manzoni

Paes

et al. 2016

Infect Dis Ther

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IntroductionThe REGAL (RSV Evidence—a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This second publication covers the risk and burden of RSV infection in preterm infants born at <37 weeks’ gestational age (wGA) without chronic lung disease or congenital heart disease.MethodsA systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015. Studies reporting data for hospital visits/admissions for RSV infection among preterm infants as well as studies reporting RSV-associated morbidity, mortality, and risk factors were included. Study quality and strength of evidence (SOE) were graded using recognized criteria.Results2469 studies were identified of which 85 were included. Preterm infants, particularly those born at lower wGA, tended to have higher RSV hospitalization (RSVH) rates compared with otherwise healthy term infants (high SOE). RSVH rates ranged from ~5 per 1000 children to >100 per 1000 children with the highest rates shown in the lowest gestational age infants (high SOE). Independent risk factors associated with RSVH include: proximity of birth to the RSV season, living with school-age siblings, smoking of mother during pregnancy or infant exposure to environmental smoking, reduced breast feeding, male sex, and familial atopy (asthma) (high SOE). Predictive models can identify 32/33–35 wGA infants at risk of RSVH (high SOE).ConclusionRSV infection remains a major burden on Western healthcare systems and is associated with significant morbidity. Further studies focusing on the prevalence and burden of RSV in different gestational age cohorts, the changing risk of RSVH during the first year of life, and on RSV-related mortality in preterm infants are needed to determine the true burden of disease.FundingAbbVie.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0130-1) contains supplementary material, which is available to authorized users.

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Incidence and risk factors of hospitalization for bronchiolitis in preterm children: a retrospective longitudinal study in Italy

Cited by 26 publications

References 21 publications

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

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