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Published on: August 7, 2017
Risk factors for recurrent wheezing in preterm infants who received prophylaxis with palivizumab
Mariana Bueno Manini1, Natasha Yumi Matsunaga1,2, Lívea Gianfrancesco1,2
1. Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil.
Insights
Recurrent wheezing (RW) affects 27.1% of preterm infants receiving respiratory syncytial virus (RSV) prophylaxis. A history of atopy or bronchopulmonary dysplasia significantly increases the risk of RW in these infants.
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Preterm infants are at increased risk for respiratory infections and complications.
- Respiratory syncytial virus (RSV) prophylaxis is crucial for protecting vulnerable infants.
- Recurrent wheezing (RW) is a common respiratory issue in early childhood.
Purpose of the Study:
- To determine the prevalence of recurrent wheezing (RW) in preterm infants receiving respiratory syncytial virus (RSV) prophylaxis.
- To identify genetic susceptibility, such as atopy or asthma, and risk factors for RW in this population.
Main Methods:
- A cross-sectional study was conducted with 410 preterm infants who received palivizumab prophylaxis.
- Data was collected via structured questionnaires administered through face-to-face interviews with parents or legal guardians.
- Infants were assessed within the first two years of life at a referral center in Brazil.
Main Results:
- The overall prevalence of RW was 27.1% (111 out of 410 infants).
- No significant differences in RW prevalence were found based on sex, ethnicity, gestational age, birth weight, or breastfeeding.
- Bronchopulmonary dysplasia (BPD) doubled the risk of RW (adjusted OR = 2.08), and a personal/family history of atopy increased the risk nearly fivefold (adjusted OR = 4.96).
Conclusions:
- Preterm infants receiving RSV prophylaxis with a history of atopy or bronchopulmonary dysplasia are at a significantly higher risk for recurrent wheezing.
- These findings highlight the importance of considering underlying conditions like atopy and BPD when assessing respiratory risks in preterm infants.
- Targeted monitoring and interventions may be beneficial for preterm infants with these risk factors.
Objective:
To determine the prevalence of recurrent wheezing (RW) in preterm infants who received prophylaxis against severe infection with respiratory syncytial virus (RSV) and to identify genetic susceptibility (atopy or asthma) and risk factors for RW.
Methods:
This was a cross-sectional study involving preterm infants who received prophylaxis with palivizumab at a referral center in Brazil during the first two years of age. A structured questionnaire was administered in a face-to-face interview with parents or legal guardians.
Results:
The study included 410 preterm infants (median age = 9 months [0-24 months]). In the sample as a whole, 111 children (27.1%; [95% CI, 22.9-31.5]) had RW. The univariate analysis between the groups with and without RW showed no differences regarding the following variables: sex, ethnicity, maternal level of education, gestational age, birth weight, breastfeeding, number of children in the household, day care center attendance, pets in the household, and smoking caregiver. The prevalence of RW was twice as high among children with bronchopulmonary dysplasia (adjusted OR = 2.08; 95% CI, 1.11-3.89; p = 0.022) and almost five times as high among those with a personal/family history of atopy (adjusted OR = 4.96; 95% CI, 2.62-9.39; p < 0.001) as among those without these conditions.
Conclusions:
Preterm infants who received prophylaxis with palivizumab but have a personal/family history of atopy or bronchopulmonary dysplasia are more likely to have RW than do those without these conditions.
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