Even mildly premature infants (gestational ages of 33 weeks through 36 weeks) have an increased risk of medically attended respiratory syncytial virus infection, which is the leading cause of lower respiratory tract infection in infants and young children and can lead to pneumonia in babies, according to a Kaiser Permanente Division of Research study. The RSV infection risk is higher among infants exposed to supplemental oxygen or assisted ventilation during the neonatal period, said the researchers, explaining that the need for oxygen is sometimes unavoidable for babies who need intensive care.
The results of the study are being presented at the Pediatric Academic Societies Annual Meeting to be held in Baltimore on Tuesday, May 5.
"Although extreme prematurity is a known risk factor for severe RSV infection, this study helped us to learn more about risk factors for RSV infection among mildly premature infants. We detected an increased risk even in babies born at 37 weeks," said the study's lead investigator Gabriel J. Escobar, MD, a hospital-based pediatrician and research scientist with the Kaiser Permanente Division of Research in Oakland, Calif. "Further research is needed to determine whether strategies to prevent or mitigate RSV infections are indicated in late preterm infants."
The study included 108,794 babies at least 33 weeks gestation discharged from six Kaiser Permanente hospitals between January 1996 and December 2002. Compared to babies 38-40 weeks, babies born at 37 weeks had a 37 percent increased odds of RSV infection, while babies born at 34-36 weeks had a 70 percent increased odds. In contrast, babies born at 41 or more weeks had 14 percent decreased odds. Even after controlling for prematurity, babies who received supplemental oxygen during the birth hospitalization had a 50 to 120 percent increased odds of medically attended RSV infection in the first year of life.
Researchers used a retrospective cohort study design using logistic regression and Cox proportional hazards modeling to control for varying follow-up lengths.
Additional researchers on the study include: Patricia Kipnis, Ph.D., Arona Ragins, MA, Sherian Xu Li, MS, and Laura Prager, MD, Pharm D, all with Kaiser Permanente; and Jennifer Graff with Medimmune.
Funding was provided by Medimmune, LLC.
About the Kaiser Permanente Division of Research (http://www.dor.kaiser.org/)
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR's 400-plus staff is working on more than 250 epidemiological and health services research projects.
About Kaiser Permanente Research
Kaiser Permanente's eight research centers comprise one of the largest research programs in the United States and engage in work designed to improve the health of individuals everywhere. KP HealthConnect™ , Kaiser Permanente's electronic health record, and other resources provide population data for research, and in turn, research findings are fed into KP HealthConnect™ to arm physicians with research and clinical data. Kaiser Permanente's research program works with national and local health agencies and community organizations to share and widely disseminate its research data. Kaiser Permanente's research program is funded in part by Kaiser Permanente's Community Benefit division, which in 2007 directed an estimated $1 billion in health services, technology, and funding toward total community health.
About Kaiser Permanente
Kaiser Permanente is shaping the future of health care. We are America's leading health care provider and not-for-profit health plan. Founded in 1945, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. In 2008, Kaiser Permanente proudly directed approximately $1.17 billion to support community benefit programs and services through research, community-based health partnerships, and direct health coverage for low-income families and collaboration with community clinics, health departments and public hospitals. For more information, go to www.kp.org/newscenter