1228. Persistent Recurrent Wheezing in the Fifth Year of Life After Laboratory-confirmed RSV Infection in Infancy
Session: Poster Abstract Session: RSV and Other Viral Respiratory Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 1228_GerryJohnson_GabrielEscobar.pdf (88.4 kB)
  • Background: Respiratory syncytial virus (RSV) infection is responsible for 50-80% of bronchiolitis hospitalizations in young children.   We examined the relationship between recurrent wheezing (RW) in the fifth year of life and documented RSV infection, prematurity, and neonatal oxygen exposure during infancy.

    Methods: This retrospective cohort study was conducted in an integrated health care system in Northern California and linked inpatient, outpatient, laboratory, and pharmacy databases for cohort assembly. Study participants were 72,602 children born in 1996-2004 at ≥32 weeks gestational age (GA). The principal exposure was laboratory-confirmed, medically-attended RSV infection during the first year of life. The study outcome was recurrent wheezing (RW), quantified by outpatient visits, inpatient hospital stays, or asthma prescriptions, in the 2nd, 3rd, 4th, 5th, and 2nd - 5th year of life. Logistic regression was used to determine the predictors of RW in the 5th year of life.

    Results: The prevalence of RW in the 5th year of life among premature infants with and without laboratory-confirmed, medically-attended RSV was 9.09% and 6.51%, respectively.  Compared to infants without RSV, all infants with RSV in the first year of life had a higher prevalence of RW across all study years (20.70% vs. 5.37% in year 2, 13.11% vs. 4.66% in year 3, 12.16% vs. 4.64% in year 4, 7.90% vs. 4.60% in year 5, and 31.83% vs. 12.26% in years 2-5).  Infants having an RSV outpatient encounter (adjusted odds ratio [AOR] 1.38, 95% CI, 1.03 - 1.85), uncomplicated RSV hospitalization (1.98, 95% CI, 1.39 - 2.81), or prolonged RSV hospitalization (2.59, 95% CI, 1.49 - 4.50) were at increased risk for RW compared to infants without RSV. GA of 32 - 33 weeks (1.49, 95% CI, 1.15 - 1.92) and 34 - 36 weeks (1.30, 95% CI 1.14 - 1.48) were associated with increased risk for RW compared to 38 - 40 weeks. Supplemental oxygen exposure was associated with increased risk of RW.

    Conclusion: Laboratory-confirmed, medically-attended RSV infection during infancy had a persistent effect on the prevalence of recurrent wheezing by the 5th year of life in addition to prematurity and neonatal oxygen exposure.  Additional studies are warranted.

    The study was sponsored by MedImmune, LLC.


    Subject Category: P. Pediatric and perinatal infections

    Gabriel Escobar, MD1, Eileen Walsh, RN, MPH1, Sherian Li, MS1, Anthony Masaquel, PhD, MPH2 and Patricia Kipnis, PhD1, (1)Kaiser Permanente Medical Care Program, Oakland, CA, (2)MedImmune, LLC, Gaithersburg, MD

    Disclosures:

    G. Escobar, MedImmune, LLC: Research Contractor, Grant recipient and Research grant

    E. Walsh, MedImmune, LLC: Research Contractor, Grant recipient and Research grant

    S. Li, MedImmune, LLC: Research Contractor, Grant recipient and Research grant

    A. Masaquel, MedImmune, LLC: Employee, Salary

    P. Kipnis, MedImmune, LLC: Research Contractor, Grant recipient and Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.