Prospective study of healthcare utilisation and respiratory morbidity due to RSV infection in prematurely born infants

Simon Broughton ¹, Alison Roberts ¹, Grenville Fox ¹, Elena Pollina ¹, Mark Zuckerman ¹, Shenila Chaudhry ¹ and Anne Greenough ^1*

¹ Guy's, King's and St Thomas' School of Medicine, King's College London, United Kingdom

^* To whom correspondence should be addressed. E-mail: anne.greenough{at}kcl.ac.uk.

Accepted 25 September 2005

Abstract

Aim: To determine the impact of respiratory syncytial virus (RSV) infection, both in hospital and the community, on healthcare utilisation and respiratory morbidity in prematurely born infants and identify risk factors for symptomatic RSV infection.

Method: A hospital and community follow up study was undertaken of 126 infants born prior to 32 weeks of gestational age. Health care utilisation (hospital admissions and general practitioner attendances) in the first year, respiratory morbidity at follow up (wheeze and cough documented by parent completed diary cards) and RSV positive lower respiratory tract infections (LRTIs) were documented. Nasopharyngeal aspirates were obtained for immunofluorescence and culture for RSV whenever the infants had a LRTI, either in the community or in hospital.

Results: Forty two infants had an RSV positive LRTI (RSV group), 50 had an RSV negative LRTI (RSV negative LRTI group) and 32 infants no LRTI (no LRTI group). Compared to the RSV negative LRTI or the no LRTI groups, the RSV group required more admissions (p<0.001, p=0.392) and days in hospital (p<0.001, p=0.004) and had more cough (p=0.05, p=0.038) and wheeze (p=0.003, p=0.003) at follow up. Significant risk factors for symptomatic RSV LRTI were number of siblings (p=0.035) and maternal smoking in pregnancy (p=0.005) and for cough were number of siblings (p=0.002) and RSV LRTI (p=0.02) and for wheeze was RSV LRTI (p=0.019).

Conclusion: We conclude RSV infection, even if hospital admission is not required, is associated with increased subsequent respiratory morbidity in prematurely born infants.

Keywords: RSV infection, healthcare utilisation, premature

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