Risk of RSV-related hospitalization is associated with gestational age in preterm (born at 29-34 wGA) infants without

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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

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Elizabeth R Packnett1, Isabelle H Winer1, Abiola Oladapo2

  • 1Real World Data Research & Analytics, Merative, Ann Arbor, MI, USA.

Human Vaccines & Immunotherapeutics
|October 13, 2023
PubMed

Insights

Preterm infants born at 29-34 weeks gestational age (wGA) face significantly higher respiratory syncytial virus hospitalization (RSVH) risks and severity compared to term infants. Palivizumab may reduce these risks and severity in vulnerable preterm infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Palivizumab (PZV) is a monoclonal antibody proven to reduce respiratory syncytial virus hospitalization (RSVH) risk and severity.
  • American Academy of Pediatrics (AAP) guidelines for PZV administration have evolved, with recommendations changing in 2014 for preterm infants born at 29 weeks gestational age (wGA) or later.
  • Understanding RSVH risk and severity in preterm infants without comorbidities is crucial, especially following changes in prophylaxis recommendations.

Purpose of the Study:

  • To describe the risk and severity of RSVH in preterm infants (29-34 wGA) without comorbidities.
  • To compare RSVH risk and severity in these preterm infants relative to healthy term infants.
  • To analyze RSVH risk and severity by gestational age within the preterm infant cohort.

Main Methods:

  • Utilized MarketScan Multi-State Medicaid and Commercial Databases for infants born between July 1, 2014, and June 30, 2019.
  • Identified preterm infants (29-34 wGA) and term infants (>37 wGA) without outpatient PZV administration.
  • Evaluated claims during RSV seasons (November-March, 2014-2020) for infants <6 months old to assess RSVH and its characteristics.

Main Results:

  • RSVH rates were higher in infants with lower wGA at birth, ranging from 3.32-5.72 per 100 infant-seasons (Medicaid) and 3.21-4.84 (commercial insurance).
  • Preterm infants faced a 5-8 times higher relative risk of RSVH (Medicaid) and 3-5 times higher (commercial insurance) compared to term infants.
  • ICU admissions, mechanical ventilation, and outpatient healthcare utilization for RSV were significantly more common in preterm infants, particularly those born at 31-34 wGA.

Conclusions:

  • Preterm infants (29-34 wGA) without comorbidities exhibit substantially higher RSVH risk and severity compared to term infants.
  • Gestational age at birth is a significant determinant of RSVH risk and severity within the preterm population.
  • Increased palivizumab utilization in preterm infants (29-34 wGA) could potentially decrease RSVH rates and mitigate disease severity.

Keywords:
Respiratory syncytial virusinfantintensive care unitspediatricpediatric hospitalizationprematurerespiratory tract infections

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