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Influenza hospitalizations during childhood in children born preterm
Siri H Hauge1,2, Birgitte Freiesleben de Blasio1,2, Siri E Håberg3
1Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
Insights
Children born preterm face a significantly higher risk of influenza hospitalization by age five. This increased risk, particularly for very preterm infants, highlights the importance of influenza vaccination for this vulnerable population.
Area of Science:
- Pediatric Health
- Infectious Disease Epidemiology
- Neonatal Medicine
Background:
- Preterm birth is associated with various health complications in early childhood.
- Influenza hospitalization represents a significant burden on healthcare systems, especially for high-risk infants.
- Understanding the specific risks for preterm infants is crucial for targeted preventive strategies.
Purpose of the Study:
- To investigate the association between preterm birth and the risk of influenza hospitalization up to five years of age.
- To quantify the risk of influenza hospitalization across different categories of preterm and early-term births.
- To inform public health recommendations regarding influenza vaccination for preterm infants.
Main Methods:
- Utilized national registry data of children born in Norway between 2008 and 2011.
- Employed Cox regression models to estimate adjusted hazard ratios (aHRs) for influenza hospitalizations.
- Analyzed data for preterm (<37 weeks), very preterm (<32 weeks), early term (37-38 weeks), and post-term (≥42 weeks) infants.
Main Results:
- Children born preterm exhibited a substantially higher risk of influenza hospitalization before age five (aHR 2.33).
- The risk of hospitalization increased with decreasing gestational age, with extremely/very preterm infants showing the highest risk (aHR 4.07).
- Early-term infants (37-38 weeks) also demonstrated an elevated risk compared to term-born infants.
Conclusions:
- Preterm birth is a significant risk factor for influenza hospitalization in the first five years of life.
- Early-term birth is also associated with an increased risk of influenza hospitalization.
- Influenza vaccination programs should prioritize and potentially expand coverage for preterm and early-term infants.
Objective:
The objective is to determine if children born preterm were at increased risk of influenza hospitalization up to age five.
Methods:
National registry data on all children born in Norway between 2008 and 2011 were used in Cox regression models to estimate adjusted hazard ratios (aHRs) for influenza hospitalizations up to age five in children born preterm (<37 pregnancy weeks). HRs were also estimated separately for very preterm (<32 weeks), early term (37-38 weeks), and post-term (≥42 weeks) children.
Results:
Among 238,628 children born in Norway from January 2008 to December 2011, 15,086 (6.3%) were born preterm. There were 754 (0.3%) children hospitalized with influenza before age five. The rate of hospitalizations in children born preterm was 13.8 per 10,000 person-years (95% confidence interval [CI] [11.3, 16.7]), and 5.9 per 10,000 person-years (95% CI [5.5, 6.4]) in children born at term (≥37 weeks). Children born preterm had a higher risk of influenza hospitalization before age 5: aHR 2.33 (95% CI [1.85, 2.93]). The risk increased with decreasing gestational age and was highest among those born extremely/very preterm; aHR 4.07 (95% CI [2.63, 6.31]). Compared with children born at 40-41 weeks, children born early term also had an elevated risk of influenza hospitalization; aHR (37 weeks) 1.89 (95% CI [1.43, 2.50]), aHR (38 weeks) 1.43 (95% CI [1.15, 1.78]).
Conclusion:
Children born preterm had a higher risk of influenza hospitalizations before age five. An elevated risk was also present among children born at an early term. Children born preterm could benefit from influenza vaccinations.
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