Marie-Laure Charkaluk1,2,3, Jessica Rousseau4, Marine Dehouck-Vallois5, Pierre-Henri Jarreau6,7, Alexandra Nuytten8,9, Ludovic Treluyer6,10, Pierre-YvesY Ancel6,4, Héloïse Torchin6,7. 1. Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France. charkaluk.marie-laure@ghicl.net. 2. Service de néonatologie, Hôpital Saint Vincent de Paul, GHICL, Boulevard de Belfort, 59020, Lille cedex, France. charkaluk.marie-laure@ghicl.net. 3. Université Catholique de Lille, F-59000, Lille, France. charkaluk.marie-laure@ghicl.net. 4. CIC P1419, AP-HP, APHP.CUP, F-75014, Paris, France. 5. Service de pédiatrie, Centre Hospitalier de Calais, F-62100, Calais, France. 6. Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France. 7. Department of Neonatal Medicine, Cochin Port-Royal Hospital, FHU PREMA, APHP.centre, Paris, France. 8. Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France. 9. Clinique de néonatalogie, Hôpital Jeanne de Flandre, CHU Lille, F-59000, Lille, France. 10. CHU Amiens-Picardie, F-80054, Amiens, France.
Abstract
This study aims to describe the incidence of acute respiratory infections (ARI) during the first year in infants born before 32 weeks' gestation, and to analyze and study the risk factors as well as factors associated with oxygen requirement among infants with an ARI, in the palivizumab era. This study included 2571 infants from a nationwide French population-based cohort (Epipage 2). ARI at 1-year corrected age was identified by parental questionnaires. Risk and severity factors included those already known, and detailed information about neonatal morbidities. ARI occurred in 52.2% (n = 1349) of infants. Oxygen therapy was used in 33.2% (n = 391) of infants with an ARI. Risk factors for AII were male sex, bronchopulmonary dysplasia, presence of siblings at home, and childcare in the community together with incomplete treatment palivizumab. Mechanical ventilation in the neonatal period, bronchopulmonary dysplasia, and discharge between October and March were associated with more frequent oxygen requirement. No other factors describing neonatal morbidities were associated with risk of ARI or oxygen requirement. Conclusion: ARIs are still very common during the first year of life of very preterm children, and oxygen therapy is frequently needed. Educational strategies are needed in all families with a very preterm infant. What is Known: • Acute respiratory infections (ARIs) are the first cause of rehospitalizations in preterm children, with bronchopulmonary dysplasia being the main risk factor. • Palivizumab prophylaxis has proven its effect against severe RSV infections, but it is not universal. What is New: • No factor describing neonatal morbidity, except BPD, was associated with ARI occurrence or severity. • BPD and discharge during RSV season were the only factors associated with O2 requirement during ARI.
This study aims to describe the incidence of acute respiratory infections (ARI) during the first year in infants born before 32 weeks' gestation, and to analyze and study the risk factors as well as factors associated with oxygen requirement among infants with an ARI, in the palivizumab era. This study included 2571 infants from a nationwide French population-based cohort (Epipage 2). ARI at 1-year corrected age was identified by parental questionnaires. Risk and severity factors included those already known, and detailed information about neonatal morbidities. ARI occurred in 52.2% (n = 1349) of infants. Oxygen therapy was used in 33.2% (n = 391) of infants with an ARI. Risk factors for AII were male sex, bronchopulmonary dysplasia, presence of siblings at home, and childcare in the community together with incomplete treatment palivizumab. Mechanical ventilation in the neonatal period, bronchopulmonary dysplasia, and discharge between October and March were associated with more frequent oxygen requirement. No other factors describing neonatal morbidities were associated with risk of ARI or oxygen requirement. Conclusion: ARIs are still very common during the first year of life of very preterm children, and oxygen therapy is frequently needed. Educational strategies are needed in all families with a very preterm infant. What is Known: • Acute respiratory infections (ARIs) are the first cause of rehospitalizations in preterm children, with bronchopulmonary dysplasia being the main risk factor. • Palivizumab prophylaxis has proven its effect against severe RSV infections, but it is not universal. What is New: • No factor describing neonatal morbidity, except BPD, was associated with ARI occurrence or severity. • BPD and discharge during RSV season were the only factors associated with O2 requirement during ARI.