PAEDIATRIC LUNG DISEASE

School age outcome of hospitalisation with respiratory syncytial virus infection of prematurely born infants

A Greenough¹, J Alexander², P Boit², J Boorman³, S Burgess⁴, A Burke⁵, P A Chetcuti⁴, I Cliff², W Lenney², T Lytle³, C Morgan⁵, C Raiman¹, N J Shaw⁵, K P Sylvester¹, J Turner⁶

¹ King’s College London, MRC-Asthma Centre, Division of Asthma, Allergy and Lung Biology, London, UK
² University Hospital of North Staffordshire, Stoke on Trent, UK
³ Abbott Laboratories, Maidenhead, UK
⁴ Leeds General Infirmary, Leeds, UK
⁵ Liverpool Women’s Hospital, Liverpool, UK
⁶ Premier Research Group, Crowthorne, UK

Professor A Greenough, 4th Floor, Golden Jubilee Wing, King’s College Hospital, London SE5 8RS, UK; anne.greenough{at}kcl.ac.uk

Background: Hospitalisation due to respiratory syncytial virus (RSV) infection in the first 2 years after birth has been associated with increased healthcare utilisation and associated costs up to 5 years of age in children born prematurely at less than 32 weeks of gestation who developed bronchopulmonary dysplasia (BPD). A study was undertaken to determine whether hospitalisation due to RSV infection in the first 2 years was associated with increased morbidity and lung function abnormalities in such children at school age, and if any effects were influenced by age.

Methods: Healthcare utilisation and cost of care in years 5–7 were reviewed in 147 children and changes in healthcare utilisation between 0 and 8 years were assessed also using results from two previous studies. At age 8–10 years, 77 children had their lung function assessed and bronchial hyper-responsiveness determined.

Results: Children hospitalised with RSV infection (n = 25) in the first 2 years had a greater cost of care related to outpatient attendance than those with a non-respiratory or no admission (n = 72) when aged 5–7 years (p = 0.008). At 8–10 years of age, children hospitalised with RSV infection (n = 14) had lower forced expiratory volume in 0.75 s (FEV_0.75) (p = 0.015), FEV_0.75/forced vital capacity (p = 0.027) and flows at 50% (p = 0.034) and 75% (p = 0.006) of vital capacity than children hospitalised for non-RSV causes (n = 63). Healthcare utilisation decreased with increasing age regardless of RSV hospitalisation status.

Conclusions: In prematurely born children who had BPD, hospitalisation due to RSV infection in the first 2 years is associated with reduced airway calibre at school age.

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This article has been cited by other articles:

• Greenough, A. (2009). Does Low Birth Weight Confer a Lifelong Respiratory Disadvantage?. Am. J. Respir. Crit. Care Med. 180: 107-108 [Full Text]