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Preterm infants at increased risk for infection-related hospital admissions until adulthood
Recent findings published in Lancet Infectious Diseases showed that infants born with reduced gestational age, weight and length have increased rates of infection-related hospital admissions until age 18 years.
“Our study shows that the health implications of being born even slightly premature and underweight can last throughout childhood,” David P. Burgner, PhD, group leader at Murdoch Childrens Research Institute in Parkville, Australia, told Infectious Diseases in Children. “Although we have known that extremely premature children have greater risk of infection as babies, the increased risk in those born toward term or near-normal birth weight has not been well-recognized, nor the fact that it persists until adolescence.”
David P. Burgner
The researchers performed a population-based study using registry data of 719,311 nonindigenous Australian singleton births from 1980 through 2010. The researchers followed each patient for admission data until age 18 years, death or 2010. The primary outcomes were the number and type of infection-related hospital admissions. They adjusted risk ratios for maternal age at delivery, birth year, birth season, parity, sex, 5-minute Apgar score, delivery method, socioeconomic status and bronchopulmonary dysplasia.
The researchers observed that 30% of all children had at least one infection-related hospital admission, with 19% having one admission, 6% having two admissions, 2% having three and 2% having four or more. Of children admitted to the hospital, 48% had upper respiratory tract infections, 20% had lower respiratory tract infections, 12% had gastrointestinal tract infections, and 10.1% were infected with a virus. For children with a gestational age less than 39 weeks, infection-related hospital admission rates increased by 12% for each week reduction in gestational age (RR = 1.12; 95% CI, 1.12-1.13). For children weighing less than 3,000 to 3,500 grams, admission rates increased by 19% for each 500-gram reduction in birthweight (RR = 1.19; 95% CI, 1.18-1.21). Children with a birth length less than 45 to 50 cm, admission rates increased by 41% for each 5-cm reduction (RR = 1.41; 95% CI, 1.38-1.45).
“The results are of particular relevance to low-income and middle-income countries, where around 43.3 million infants are born preterm, of low birthweight, or small for their gestational age,” Burgner said. “The next step is to identify LMI populations where these data are available; we would be keen to hear from researchers interested in working with us on this important question.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
