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Respiratory Syncytial Virus Preterm (32–36 Completed Weeks of Gestation) Risk Estimation Measure for RSV Hospitalization in Ireland: A Prospective Study

Sheridan-Pereira, Margaret FRCPI*†; Murphy, Joan PhD*†; Sloan, Julie RM*; Crispino, Gloria PhD; Leahy, Anne FRCPI§; Corcoran, J. David FRCPI†††; Dempsey, Eugene FRCPI; Elnazir, Basil FRCPI**; Gavin, Patrick FRCPI‡¶; Sharif, Farhana FRCPI‡‡; Gul, Rizwan FRCPI§§; Satas, Salius PhD¶¶; Murphy, John FRCPI‖‖; Gormally, Siobhan FRCPI***; Shanaa, Issam FRCPI†††; Waldron, David FRCPI‡‡‡; Mc Mahon, Paul FRCPI§§§; Carson, John FRCPI¶¶¶; Blanken, Maarten MD, MSc‖‖‖; Bont, Louis MD, PhD‖‖‖; Paes, Bosco FRCPC****

Pediatric Infectious Disease Journal: January 2016 - Volume 35 - Issue 1 - p 19–24
doi: 10.1097/INF.0000000000000918
Original Studies

Background: In several countries, respiratory syncytial virus prophylaxis is offered to late preterm infants who are at escalated risk of respiratory syncytial virus hospitalization (RSVH). However, targeted prophylaxis should be informed by country-specific data. This study, which uniquely includes 36 weeks of gestational age (GA) infants, aims to establish the risk factors for RSVH in 32–36 weeks of GA infants in Ireland.

Methods: A prospective observational study at 13 hospitals of laboratory-confirmed RSVH in nonprophylaxed 32–36 weeks of GA infants was conducted from July 2011 to February 2014. Baseline and first-year clinical data were analyzed by using SPSS software Version 22 (IBM Corp, Armonk, NY). Significant (P < 0.05) variables were entered into multiple logistic regression to determine the independent risk factors for RSVH.

Results: Sixty-three percent of eligible infants (1825 of 2877) were recruited. The RSVH rate was 3.6% (65 of 1807 analyzed infant records). There was no RSV-attributable mortality. Twelve infants required intensive care. Of the 15 variables correlating to RSVH, 5 independent risk factors were identified: older siblings [odds ratio (OR): 3.8; 95% confidence interval (CI): 1.97–7.41], being Caucasian (OR: 2.3; 95% CI: 1.04–5.29), neonatal respiratory morbidity (OR: 2.2; 95% CI: 1.28–3.94); birth July 15 to December 15 (OR: 2.1; 95% CI: 1.09–3.92) and family history of asthma (OR: 1.9; 95% CI: 1.01–3.39). Birth from 36 weeks to 36 + 6 days mitigated RSVH risk (relative risk: 0.58; 95% CI: 0.34–0.99); however, risk factors were similar to the 32–35 weeks of GA cohort.

Conclusion: Neonatal respiratory morbidity or being Caucasian were the population-specific independent risk factors for RSVH in 32–36 weeks of GA in Ireland, whereas the other identified independent risk factors mirrored those established in previous studies.

From the *Department of Paediatrics and Newborn Medicine, Coombe Women and Infants University Hospital, Dublin; Department of Paediatrics, Trinity College Dublin, Dublin; National Children’s Research Centre, Our Lady’s Children’s Hospital Crumlin, Crumlin, Dublin; §Department of Pediatrics, Cavan General Hospital, Cavan, Dublin; Children’s University Hospital, Dublin; Department of Paediatrics, Cork University Maternity Hospital, Wilton, Cork; **Department of Paediatrics, AMNCH Tallaght Hospital, Dublin; ††Department of Paediatrics, Rotunda Hospital, Dublin; ‡‡Department of Pediatrics, Midlands Regional Hospital, Mullingar; §§Department of Pediatrics, Midlands Regional Hospital, Portlaoise; ¶¶Department of Pediatrics, Mt. Carmel Hospital, Dublin; ‖‖Department of Pediatrics, National Maternity Hospital, Dublin; ***Department of Pediatrics, Our Lady of Lourdes Hospital, Drogheda, Co Louth; †††Department of Pediatrics, South Tipperary General Hospital, Clonmel; ‡‡‡Department of Pediatrics, St. Luke’s Hospital, Kilkenny; §§§Department of Pediatrics, Waterford Regional Hospital, Waterford; ¶¶¶Department of Pediatrics, Wexford General Hospital, Wexford, Ireland; ‖‖‖Division of Pediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands; and ****Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada.

Accepted for publication September 2, 2015.

This investigator-driven study was funded by Abbott/AbbVie Laboratories. J.S. and J.M. were funded part time to undertake the study. Neither the principal investigator, M.S.-P., nor the other coauthors received funding. M.S.-P. received honorarium for respiratory syncytial virus advisory board meetings, which were sponsored by Abbott/AbbVie Laboratories in 2013. J.M. received speakers honoraria from AbbVie in 2012 and 2013; J.D.C. and J.C. were sponsored by AbbVie/Abbott to attend an AbbVie-sponsored event. B.E. received funding from Abbott for a cystic fibrosis study and was sponsored to attend Global Experts Meetings. L.B. has received research funds and/or speaker’s fees from AbbVie, MedImmune, Johnson and Johnson, Gilead and GSK (all received by institution). B.P. has received speaker’s fees from AbbVie Corporation. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Margaret Sheridan-Pereira, FRCPI, Department of Paediatrics and Newborn Medicine, Coombe Women and Infants University Hospital, and Department of Paediatrics, Trinity College Dublin, Cork Street, Dublin 8, Ireland. E-mail drmargaretsheridan@gmail.com.

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