Hospital admissions for lower respiratory tract infections in children born moderately/late preterm
Paula Haataja1,2, Päivi Korhonen1,2, Riitta Ojala1,2
1Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Insights
Infants born moderately preterm (MP) and late preterm (LP) face higher risks of hospital admissions for lower respiratory tract infections (LRTIs) compared to term infants. These risks, while lower than very preterm (VP) infants, are significant and influenced by factors like maternal smoking and birth complications.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Preterm birth is a major risk factor for infant morbidity.
- Lower respiratory tract infections (LRTIs) are a leading cause of hospitalization in infants.
- Understanding the specific risks associated with different degrees of preterm birth is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence of hospital admissions for LRTIs in moderately preterm (MP) and late preterm (LP) infants.
- To compare these rates with very preterm (VP) and term (T) infants.
- To identify predictors of LRTIs in these populations.
Main Methods:
- A national register-based study in Finland (1991-2008) analyzed over 1 million infants.
- Infants were categorized into four gestational age groups: VP (<32 weeks), MP (32-33 weeks), LP (34-36 weeks), and T (≥37 weeks).
- Data on hospital admissions for bronchiolitis/bronchitis and pneumonia up to age 7 were collected and analyzed.
Main Results:
- Hospital admissions for LRTIs were more frequent in MP and LP infants than in term infants, but less frequent than in VP infants.
- MP and LP births significantly predicted admissions for bronchiolitis/bronchitis and pneumonia compared to term births.
- Maternal smoking, cesarean section, male sex, neonatal unit admission, and ventilator therapy were significant risk factors for LRTIs.
Conclusions:
- Moderately preterm and late preterm births significantly increase the risk of respiratory infectious morbidity and hospital admissions for LRTIs.
- These findings highlight the continued vulnerability of preterm infants to respiratory infections beyond the neonatal period.
- Public health strategies should consider the elevated risk of LRTIs in moderately and late preterm infants.
Objective:
To evaluate the frequency and predictors of hospital admissions for lower respiratory tract infections (LRTIs) in moderately preterm (MP, 32+0 to 33+6 weeks) and late preterm (LP, 34+0 to 36+6 weeks) infants compared to term (T ≥37 weeks) and very preterm (VP, <32+0 weeks) infants.
Study Design:
This national register-based study covered all infants born in Finland in 1991-2008. Data on 1 018 256 infants were analyzed in four gestational age-based groups: VP (n = 6329), MP (n = 6796), LP (n = 39 928), and T (n = 965 203) groups. Data on hospital admissions due to bronchiolitis/bronchitis and pneumonia were collected up to the age of 7 years.
Results:
Hospital admissions for LRTIs were more common in the MP and LP groups than in the T group but less frequent than in the VP group: bronchiolitis/bronchitis (VP 24.4%, MP 13.9%, LP 9.5%, and T 5.6%) and pneumonia (VP 8.8%, MP 4.5%, LP 3.3%, and T 2.4%). Compared to the term group, MP and LP birth predicted bronchiolitis/bronchitis (MP OR 1.89; 95%CI 1.75-2.03, LP 1.51; 1.45-1.56) and pneumonia (MP 1.49; 1.32-1.67, LP 1.25; 1.18-1.33) admissions. Statistically significant risk factors for LRTIs included maternal smoking, cesarean section, male sex, admission to a neonatal unit and ventilator therapy. In addition, being first-born, being born SGA and neonatal antibiotic therapy were associated with bronchiolitis/bronchitis.
Conclusions:
MP and LP births, in addition to VP birth, have a significant impact on respiratory infectious morbidity and the need of hospital admissions for LRTIs.
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