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Occurrence and severity of acute respiratory infections during the first year among very preterm infants: an Epipage-2 cohort analysis

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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.

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Abbreviations

ARI:

Acute respiratory infection

BPD:

Bronchopulmonary dysplasia

CA:

Corrected age

CI:

Confidence interval

GA:

Gestational age

IQR:

Interquartile range

OR:

Odds ratio

RSV:

Respiratory syncytial virus

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Author information

Authors and Affiliations

  1. Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, F-75004, Paris, France

    Marie-Laure Charkaluk, Pierre-Henri Jarreau, Ludovic Treluyer, Pierre-YvesY Ancel & Héloïse Torchin

  2. Service de néonatologie, Hôpital Saint Vincent de Paul, GHICL, Boulevard de Belfort, 59020, Lille cedex, France

    Marie-Laure Charkaluk

  3. Université Catholique de Lille, F-59000, Lille, France

    Marie-Laure Charkaluk

  4. CIC P1419, AP-HP, APHP.CUP, F-75014, Paris, France

    Jessica Rousseau & Pierre-YvesY Ancel

  5. Service de pédiatrie, Centre Hospitalier de Calais, F-62100, Calais, France

    Marine Dehouck-Vallois

  6. Department of Neonatal Medicine, Cochin Port-Royal Hospital, FHU PREMA, APHP.centre, Paris, France

    Pierre-Henri Jarreau & Héloïse Torchin

  7. Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France

    Alexandra Nuytten

  8. Clinique de néonatalogie, Hôpital Jeanne de Flandre, CHU Lille, F-59000, Lille, France

    Alexandra Nuytten

  9. CHU Amiens-Picardie, F-80054, Amiens, France

    Ludovic Treluyer

Authors
  1. Marie-Laure Charkaluk
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  2. Jessica Rousseau
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  3. Marine Dehouck-Vallois
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  4. Pierre-Henri Jarreau
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  5. Alexandra Nuytten
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  6. Ludovic Treluyer
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  7. Pierre-YvesY Ancel
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  8. Héloïse Torchin
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Corresponding author

Correspondence to Marie-Laure Charkaluk.

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Conflict of interest

AbbVie France, Inc. contributed to the funding of analyses concerning palivizumab in Epipage-2. They played no role in the study design, collection, analysis, or interpretation of data, writing of the manuscript, or decision to submit the manuscript for publication. PH Jarreau is a member of the neonatal board of AbbVie France, Inc. None of the authors perceived any form of payment to produce the manuscript.

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Communicated by Daniele De Luca

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Charkaluk, ML., Rousseau, J., Dehouck-Vallois, M. et al. Occurrence and severity of acute respiratory infections during the first year among very preterm infants: an Epipage-2 cohort analysis. Eur J Pediatr 180, 1833–1840 (2021). https://doi.org/10.1007/s00431-021-03956-w

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  • DOI: https://doi.org/10.1007/s00431-021-03956-w

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