Dotan Miri, Ashkenazi-Hoffnung Liat, Samra Zmira, Livni Gilat, Yarden-Bilavsky Havatzelet, Amir Jacob, Bilavsky Efraim
Department of Pediatrics 1A, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Department of Pediatrics 2C, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Isr Med Assoc J. 2013 Nov;15(11):701-4.
Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract disease and hospitalization in infants and young children. Infants of multiple births, who are often premature, might be more susceptible to developing a more severe RSV infection than singletons.
To assess the impact of multiple births on the severity of RSV infection and define risk factors for acquiring RSV infection in infants of multiple birth.
Clinical data on infants hospitalized with RSV infection between 2008 and 2010 were retrospectively collected.
Twins comprised 7.6% (66/875) of hospitalized infants with RSV bronchiolitis during the study period. Infants in the twin group were younger (122.4 +/- 131.7 vs. 204.5 +/- 278.8 days, P = 0.014), had a lower mean gestational age (35.3 +/- 2.6 vs. 38.6 +/- 2.5 weeks, P < 0.001), and were more likely to have been born prematurely compared with singleton infants (65.6% vs. 13%, P < 0.001). On a multivariable logistic regression analysis, young age, early gestational age and male gender were the only variables identified as risk factors for pediatric intensive care unit admission (P < 0.001, P < 0.001 and P = 0.03, respectively). In contrast, the mere fact of a child being a twin was not found to be a significant risk factor for disease severity. In addition, if one twin is hospitalized due to RSV infection, the other has a 34% chance of also being hospitalized with bronchiolitis. Young age was a significant risk factor for hospitalization of the second twin (P < 0.001) CONCLUSIONS: Our findings suggest that twins hospitalized with RSV bronchiolitis do not have an increased risk for severe infection as compared to singletons. However, a twin of an infant hospitalized with RSV infection has a considerable risk of also being hospitalized with bronchiolitis, thus close monitoring is recommended.
呼吸道合胞病毒（RSV）是婴幼儿下呼吸道疾病和住院治疗的常见病因。多胞胎婴儿往往早产，可能比单胞胎婴儿更容易发生更严重的RSV感染。
评估多胞胎对RSV感染严重程度的影响，并确定多胞胎婴儿感染RSV的危险因素。
回顾性收集2008年至2010年间因RSV感染住院的婴儿的临床资料。
在研究期间，双胞胎占因RSV细支气管炎住院婴儿的7.6%（66/875）。双胞胎组的婴儿年龄更小（122.4±131.7天对204.5±278.8天，P = 0.014），平均胎龄更低（35.3±2.6周对38.6±2.5周，P < 0.001），与单胞胎婴儿相比，早产的可能性更大（65.6%对13%，P < 0.001）。在多变量逻辑回归分析中，年龄小、胎龄早和男性性别是被确定为入住儿科重症监护病房的危险因素的仅有的变量（分别为P < 0.001、P < 0.001和P = 0.03）。相比之下，孩子仅是双胞胎这一事实并未被发现是疾病严重程度的显著危险因素。此外，如果一对双胞胎中的一个因RSV感染住院，另一个有34%的机会也因细支气管炎住院。年龄小是第二个双胞胎住院的显著危险因素（P < 0.001）。结论：我们的研究结果表明，与单胞胎相比，因RSV细支气管炎住院的双胞胎发生严重感染的风险并未增加。然而，因RSV感染住院的婴儿的双胞胎有相当大的可能也因细支气管炎住院，因此建议密切监测。
