Diminished lung function, RSV infection, and respiratory morbidity in prematurely born infants

Abstract

Background: Diminished lung function appears to be a risk factor for respiratory syncytial virus (RSV) infection/bronchiolitis in term born infants. Aims: To determine if diminished lung function prior to neonatal unit discharge was associated with subsequent symptomatic RSV lower respiratory tract infection (LRTI) and respiratory morbidity in prematurely born infants. Methods: Of 39 infants in a tertiary neonatal intensive care unit (median gestational age 28 weeks, range 23-31), 20 had bronchopulmonary dysplasia. Lung function (compliance and resistance of the respiratory system (C rs and R rs ) and functional residual capacity (FRC)) was measured on the neonatal unit at 36 weeks postmenstrual age (PMA). Following neonatal unit discharge, nasopharyngeal aspirates were obtained on every occasion, at home or in hospital, an infant had an LRTI. RSV was identified by immunofluorescence and/or culture. Results: The 15 infants who suffered a symptomatic RSV LRTI had a higher mean R rs and suffered more wheeze at follow up than the rest of the cohort. Regression analysis showed that a high R rs was significantly associated with a symptomatic RSV LRTI; significant factors for cough were a high R rs and a symptomatic RSV LRTI, and for wheeze were a high R rs . Conclusion: Prematurely born infants, who had a symptomatic RSV LRTI and/or respiratory morbidity at follow up, had worse lung function prior to neonatal unit discharge.

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

“…Several risk factors for a severe course of disease during RSV infection, including premature birth [1,4], have been identified. Two studies assessed the role of neonatal lung function in RSV bronchiolitis in prematurely born infants [4,10].…”

“…Two studies assessed the role of neonatal lung function in RSV bronchiolitis in prematurely born infants [4,10]. DRYSDALE et al [10] prospectively studied 159 premature born infants that were sampled at each episode of wheeze, cough or shortness of breath.…”

“…Several risk factors, including premature birth [1,4], have been identified; however, the largest number of RSV infections occur in otherwise healthy infants without any known risk factors. Lower levels of lung function shortly after birth are associated with the occurrence of respiratory illness during the first year of life [5][6][7][8].…”

The impact of respiratory viruses on lung health after preterm birth

“…Previous genetic studies have demonstrated a significant association between the inherited polymorphisms in several immunological and surfactant protein genes and the incidence of severe viral infection and level of infection-related morbidity among preterm infants [50,51]. Also, pre-existing impairments in lung function have also been attributed to increased susceptibility to severe viral infection and infection-related morbidity among preterm infants, particularly during early life [52–54]. …”

Association of Respiratory Viral Infection and Atopy with Severity of Acute Bronchiolitis in Infants

“…관지염의 중증도가 바이러스 [2][3][4][5] 및 아토피 소견과는 무관하 거나 방어적 효과를 나타내며 [18][19][20] 이미 존재하는 폐기능 감 소 15,21) 및 유전적 요인과 관련이 있다고 제시한다. Values are presented as no.…”