Pediatrics and Neonatology Unit, Imola Hospital, Imola, Italy.
Early Hum Dev. 2011 Mar;87 Suppl 1:S43-6. doi: 10.1016/j.earlhumdev.2011.01.009. Epub 2011 Jan 31.
Respiratory syncytial virus (RSV) causes respiratory infections during the first year of life. Very premature infants have more severe diseases and also 'late preterm infants' may be more susceptible to the infection.
To evaluate in an Italian cohort the incidence and risk factors of severe hospitalized lower respiratory tract infection (LRTI) induced or not by RSV during the first year of life.
A cohort of 33(+0d)-34(+6d) wGA newborns paired with two sex- and age-matched 35(+0d)-37(+6d) wGA and ≥ 38(+0d) wGA newborns were enrolled. Hospitalization for LRTI induced or not by RSV during the first year of life was assessed through phone interview at the end of the RSV season (November-March) and at the completion of the first year of life. The parents were asked to report hospitalization for any reason.
1064 neonates were enrolled (November 2009-October 2010), 697 had at least one phone follow-up by September 2010. Babies of 33(+0d)-34(+6d) wGA were more frequently conceived through assisted fertilization technologies, born from cesarean delivery had more frequently acute perinatal risk factors and were more frequently twins. After a mean 6 month-follow-up, we registered 29 hospitalizations for LRTI induced or not by RSV. Hospitalizations were slightly and non-significantly more frequent in 33(+0d)-37(+6d) wGA infants. The risk of hospitalization was significantly 60% reduced in breastfed babies and four folds significantly increased during the RSV season.
The very preliminary data of this ongoing study suggest that in 'late-preterm' infants some individual/environmental characteristics of the infants play a relevant role in determining the risk of severe RSV infection.
呼吸道合胞病毒(RSV)会导致婴儿生命的第一年出现呼吸道感染。非常早产的婴儿病情更严重,而“晚期早产儿”可能更容易受到感染。
评估意大利队列中生命第一年因 RSV 引起或未引起的严重住院下呼吸道感染(LRTI)的发生率和危险因素。
本队列纳入了 33(+0d)-34(+6d)周出生的新生儿,配对了 2 名性别和年龄匹配的 35(+0d)-37(+6d)周和≥38(+0d)周出生的新生儿。通过在 RSV 季节(11 月至 3 月)结束时和生命的第一年结束时进行电话访谈,评估生命第一年因 RSV 引起或未引起的住院 LRTI。父母被要求报告任何原因的住院情况。
共纳入了 1064 名新生儿(2009 年 11 月至 2010 年 10 月),697 名新生儿在 2010 年 9 月前至少进行了一次电话随访。33(+0d)-34(+6d)周出生的婴儿更频繁地通过辅助受精技术受孕,剖宫产出生的婴儿更频繁地具有急性围产期危险因素,且更频繁地为双胞胎。在平均 6 个月的随访后,我们记录了 29 例因 RSV 引起或未引起的 LRTI 住院治疗。33(+0d)-37(+6d)周出生的婴儿住院治疗的情况略多,但无统计学意义。母乳喂养的婴儿住院风险显著降低了 60%,而在 RSV 季节住院风险增加了 4 倍。
这项正在进行的研究的初步数据表明,在“晚期早产儿”中,婴儿的一些个体/环境特征在决定严重 RSV 感染的风险方面起着重要作用。