RSV Hospitalisation: Preterm Infants with CLD Compared to Term Infants

Winterstein AG, Choi Y, Meissner HC. Association of Age With Risk of Hospitalization for Respiratory Syncytial Virus in Preterm Infants With Chronic Lung Disease, JAMA Pediatr. 2018 Feb 1;172(2):154-160, in press. Available from: doi: 10.1001/jamapediatrics.2017.3792.


American Academy of Pediatrics guidelines recommends RSV prophylaxis with palivizumab up to 24 months age for infants with chronic lung disease (CLD). Winterstein and colleagues conducted a retrospective cohort study consisting of 1,018,593 healthy term infants and 5181 preterm infants with CLD (42.7% vs 0.1% using palivizumab) using Medicaid billing records for 12 seasons, linked to birth and death certificates. The study indicated that when preterm infants with CLD were at 18.5 (95% CI 15.6-22.8) months, the risk of hospitalisation for RSV was similar to that of 1-month term infants with siblings. During a sensitivity analysis when the presence of young siblings was not considered, the age threshold increased to 25.5 months. This study supports the current American Academy of Pediatrics guidelines. However, interpretation should take into consideration of the inherent differences in the source population, seasonality, misclassification bias by using ICD-9-CM coding, and the trends in RSV hospitalisation over study period.

Abstract on Pubmed.