J Korean Med Sci.  2015 Oct;30(Suppl 1):S104-S110. 10.3346/jkms.2015.30.S1.S104.

Respiratory Syncytial Virus Related Readmission in Preterm Infants Less than 34 weeks' Gestation Following Discharge from a Neonatal Intensive Care Unit in Korea

• Lee JH
• Kim CS
• Chang YS
• Choi JH
• Committee on Data Collection and Statistical Analysis of the Korean Society of Neonatology

• KMID: 2351143
• DOI: http://doi.org/10.3346/jkms.2015.30.S1.S104

Abstract

This study was done to evaluate respiratory syncytial virus (RSV) related readmission (RRR) and risk factors of RRR in preterm infants < 34 weeks gestational age (GA) within 1 yr following discharge from the neonatal intensive care unit (NICU). Infants (n = 1,140) who were born and admitted to the NICUs of 46 hospitals in Korea from April to September 2012, and followed up for > 1 yr after discharge from the NICU, were enrolled. The average GA and birth weight of the infants was 30(+5) +/- 2(+5) weeks and 1,502 +/- 474 g, respectively. The RRR rate of enrolled infants was 8.4% (96/1,140), and RSV accounted for 58.2% of respiratory readmissions of infants who had laboratory tests confirming etiological viruses. Living with elder siblings (odd ratio [OR], 2.68; 95% confidence interval [CI], 1.68-4.28; P < 0.001), and bronchopulmonary dysplasia (BPD) (OR, 2.95; 95% CI, 1.44-6.04; P = 0.003, BPD vs. none) increased the risk of RRR. Palivizumab prophylaxis (OR, 0.06; 95% CI, 0.03-0.13; P < 0.001) decreased the risk of RRR. The risk of RRR of infants of 32-33 weeks' gestation was lower than that of infants < 26 weeks' gestation (OR, 0.11; 95% CI, 0.02-0.53; P = 0.006). This was a nationwide study that evaluated the rate and associated risk factors of RRR in Korean preterm infants. Preterm infants with BPD or living with siblings should be supervised, and administration of palivizumab to prevent RRR should be considered.

Keyword

Infants; Premature; Patient Readmission; Respiratory Syncytial Virus; Bronchopulmonary Dysplasia; Palivizumab

MeSH Terms

Antiviral Agents/therapeutic use
Birth Weight
Bronchopulmonary Dysplasia/drug therapy/pathology
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Male
Odds Ratio
Palivizumab/therapeutic use
Patient Discharge
Patient Readmission
Republic of Korea
Respiratory Syncytial Virus Infections/drug therapy/*pathology/virology
Respiratory Syncytial Viruses/*isolation & purification
Risk Factors
Siblings
Antiviral Agents
Palivizumab

Figure

• 

  Fig. 1 Study population. Out of the cohort that included all preterm infants less than 34 weeks' gestation who were born and survived at the NICUs of 46 hospitals in Korea from April 2012 to September 2012 (n = 1,867), the infants who were followed up for > 1 yr after discharge from the NICU, or who had readmission after discharge from the NICU were enrolled in this study (n = 1,140).

• 

  Fig. 2 Days to first respiratory syncytial virus related readmission (RRR) following discharge from the neonatal intensive care unit (Kaplan-Meier curve). No significant difference in RRR was observed when the GA was divided into five groups in all infants (n = 1,140, P = 0.159, Log-rank test for trend) (A) and in the infants with BPD (n = 326, P = 0.445, Log-rank test for trend) (B).

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