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American Academy of Pediatrics
Article

Rehospitalization for Respiratory Syncytial Virus Among Premature Infants

Steven Joffe, Gabriel J. Escobar, Steven B. Black, Mary Anne Armstrong and Tracy A. Lieu
Pediatrics October 1999, 104 (4) 894-899; DOI: https://doi.org/10.1542/peds.104.4.894
Steven Joffe
From the *Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California; the
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Gabriel J. Escobar
From the *Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California; the
‡Department of Pediatrics, Kaiser Permanente Medical Care Program, Walnut Creek, California; and the
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Steven B. Black
From the *Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California; the
§Department of Quality and Utilization, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California.
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Mary Anne Armstrong
From the *Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California; the
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Tracy A. Lieu
From the *Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, California; the
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Abstract

Objectives. New interventions to prevent respiratory syncytial virus (RSV) have recently become available. Clinical decisions about the use of these interventions require a better understanding of the incidence of and risk factors for RSV. We sought to characterize the epidemiology of severe RSV disease among premature infants and to identify high-risk subgroups.

Design. Retrospective cohort.

Setting. Kaiser Permanente Northern California, July 1992 to April 1996.

Participants. One thousand seven hundred twenty-one premature infants born at 23 to 36 weeks who were discharged from a neonatal intensive care nursery (NICU) within 12 months before the December to March RSV season. A secondary analysis included 769 infants discharged during the RSV season.

Outcome Measures. Hospitalization for RSV.

Results. Of 1721 infants already home from the NICU at the start of the season, 3.2% were rehospitalized for RSV. In a multivariate model, risk factors for RSV hospitalization included gestation ≤32 weeks (odds ratio [OR], 2.6), ≥28 days of perinatal oxygen (OR, 3.7), and NICU discharge during September to November (OR, 2.7). Predicted risk of hospitalization varied by subgroup, ranging from 1.2% to 24.6%. Among 769 infants discharged from the NICU during the RSV season, 3.5% were rehospitalized for RSV during the same season; gestation and perinatal oxygen were not associated with admission.

Conclusions. Most premature infants in this population were at less risk of severe RSV disease than previous studies in other populations have suggested. Preterm infants with a lower gestational age, a prolonged perinatal oxygen requirement, and NICU discharge within 3 months of the RSV season were most likely to require hospitalization for RSV disease. Cost-effectiveness analyses are needed to help define the role of available prophylactic interventions.

  • respiratory syncytial virus infections
  • bronchiolitis
  • epidemiology
  • neonatal infections
  • prematurity
  • infections
  • respiratory
  • intensive care
  • neonatal
  • bronchopulmonary dysplasia
  • chronic lung disease
  • seasonal variation
  • prophylaxis
  • passive immunization
  • Received December 3, 1998.
  • Accepted March 25, 1999.
  • Copyright © 1999 American Academy of Pediatrics

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Pediatrics
Vol. 104, Issue 4
1 Oct 1999
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Rehospitalization for Respiratory Syncytial Virus Among Premature Infants
Steven Joffe, Gabriel J. Escobar, Steven B. Black, Mary Anne Armstrong, Tracy A. Lieu
Pediatrics Oct 1999, 104 (4) 894-899; DOI: 10.1542/peds.104.4.894

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Rehospitalization for Respiratory Syncytial Virus Among Premature Infants
Steven Joffe, Gabriel J. Escobar, Steven B. Black, Mary Anne Armstrong, Tracy A. Lieu
Pediatrics Oct 1999, 104 (4) 894-899; DOI: 10.1542/peds.104.4.894
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Subjects

  • Pulmonology
    • Pulmonology
    • Respiratory Tract

Keywords

  • respiratory syncytial virus infections
  • bronchiolitis
  • epidemiology
  • neonatal infections
  • prematurity
  • infections
  • respiratory
  • intensive care
  • neonatal
  • bronchopulmonary dysplasia
  • chronic lung disease
  • seasonal variation
  • prophylaxis
  • passive immunization
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