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  • 2014 (1)

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Respiratory Syncytial Virus Disease in Preterm Infants in the US Born at 32-35 Weeks Gestation Not Receiving Immunoprophylaxis

by Christopher S. Ambrose; Evan Anderson; Eric A. F. Simoes; Xionghua Wu; Hanaa Elhefni; C. Lucy Park; Frangiscos Sifakis; Jessie R. Groothuis

2014

Subjects
  • Health Sciences, General
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Abstract:Close

BACKGROUND: The Respiratory Syncytial Virus (RSV) Respiratory Events Among Preterm Infants Outcomes and Risk Tracking (REPORT) study evaluated RSV disease burden in US preterm infants 32-35 weeks gestational age (wGA) not receiving RSV prophylaxis. METHODS: Preterm infants < 6 months of age as of November 1st were followed prospectively at 188 clinics from September to May 2009-2010 or 2010-2011. Nasal and pharyngeal swabs were collected for medically attended acute respiratory illnesses (MAARI) and tested for RSV by qRT-polymerase chain reaction. Risk factors were assessed using multivariate Cox proportional hazard model adjusted for seasonality. RESULTS: Of 1642 evaluable infants, 287 experienced RSV MAARI. Rates of RSV-related MAARI, outpatient lower respiratory tract illness, emergency department visits and hospitalization (RSVH) during November to March were 25.4, 13.7, 5.9 and 4.9 per 100 infant-seasons, respectively. Preschool-aged, nonmultiple-birth siblings and daycare attendance were consistently associated with increased risk of RSV. RSVH rates were highest in infants 32-34 and 35 wGA who were < 6 months of age during November to March with daycare attendance or nonmultiple-birth, preschool-aged siblings (8.9 and 9.3 per 100 infant-seasons, respectively, versus 3.5 for all other infants, P < 0.001). Chronologic age < 3 months was associated with a higher RSVH rate for infants 35 wGA but not for infants 32-34 wGA. CONCLUSIONS: In US preterm infants who were 32-35 wGA, < 6 months on November 1st and not receiving RSV prophylaxis, the burden of RSV MAARI was 25 per 100 infant-seasons. The highest RSVH rates occurred among those with daycare attendance or nonmultiple-birth, preschool-aged siblings while they were < 6 months of age during the RSV season.
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