Impact of Intercurrent Respiratory Infections on Lung Health in Infants Born <29 Weeks with BPD

Abstract

Abstract: Objective: To assess the impact of intercurrent respiratory infections on infants born <29 weeks gestation with bronchopulmonary dysplasia (BPD). Study Design: A retrospective cohort study was conducted on 111 infants born <29 weeks gestation with BPD in one academic center from 2008-2010. Results: Backward stepwise logistic regression showed viral infections significantly increased oxygen use with an OR of 15.5 [CI 3.4, 71.3]. Stratified bivariate Cochran-Mantel-Hansel chi-square analysis showed both viral and bacterial infections affected oxygen use (9% vs. 47%, p<0.0002 and 8% vs. 24%, p =0.02) with viral infections maintaining significance in the no/mild and severe BPD groups (2% vs. 40% p=0.02 and 26% vs. 83% p=0.02). Both viral and bacterial infections were associated with increased steroid use (11% to 29%, P=0.01 and 9% to 22%, p=0.03) but only viral infections were associated with an increased diuretic use in the combined BPD groups and no/mild BPD group (32% to 57%, P=0.02 and 10% to 50%, p=0.03). The Cochran-Armitage trend test showed that an increasing number of viral infections is associated with increased oxygen use (OR [95% CI] = 6.4 [2.3-17.4]), diuretic use (OR [95% CI] = 2.4 [1.1 - 5.2], p=0.02) and inhaled steroid use (OR [95% CI] = 2.2[1.003 - 5.2], p=0.049). Conclusions: Viral infections caused more long term pulmonary morbidity/mortality than bacterial infections on premature lung health over the first year of life.