Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants
Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants
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DOI：
10.3389/fped.2016.00130
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发表时间：
2016-11-30
影响因子：
2.6
通讯作者：
Goepel, Wolfgang
中科院分区：
文献类型：
--
作者：
Haertel, Christoph;Humberg, Alexander;Goepel, Wolfgang
目的：在德国新生儿网络的一项大型观察性队列研究中，我们调查了流感季节性与极低出生体重儿（VLBWI）结局之间的关系。资料与方法：在2009年7月至2014年12月的观测期内，共发生了5个流感季节（平均持续时间97天，范围48 ~ 131天）。我们根据出生日期将VLBWI （n = 10,187）分为三类：(1)流感季节前，(2)流感季节期间和(3)各自季节结束后3个月。结果通过单变量和逻辑回归分析进行评估。在婴儿亚组（n = 1497）中，评估了出生后24个月内呼吸道感染的数量。结果：流感季节出生的VLBWI患者出现临床败血症（31.0 vs. 28.2%, p = 0.014）和脑室周围白质软化（PVL, 3.7 vs. 2.5%, p = 0.004）的风险较高。在多因素logistic回归模型中，流感季节出生与PVL[比值比（OR） 1.47 (1.11-1.95), p = 0.007]和临床脓毒症[比值比（OR） 1.13 (1.01-1.27), p = 0.036]相关，独立于已知的危险因素，即胎龄、多胎、性别、小胎龄。支气管肺发育不良的风险不受流感季节的影响。在有24个月随访信息的小亚组中（n = 1497），在流感季节出生的婴儿中发现普通感冒和支气管炎发作发生率增加。结论：我们的观察数据表明，流感季节早产与PVL和败血症有关。这些都是新的方面，值得进一步调查，以解决根本原因，并包括病毒监测。
Objective: We investigated the relationship between influenza seasonality and outcome of very low birth weight infants (VLBWI) in a large observational cohort study of the German Neonatal Network.Materials and methods: Within the observational period (July 2009 until December 2014), five influenza seasons occurred (mean duration: 97 days, range: 48-131 days). We stratified VLBWI (n = 10,187) according to date of birth into three categories: (1) before influenza season, (2) during influenza season, and (3) 3 months after the end of the respective season. Outcomes were assessed in univariate and logistic regression analyses. In a subgroup of infants (n = 1497), the number of respiratory infections during the first 24 months of life was assessed.Results: VLBWI born during influenza season carried a higher risk for clinical sepsis (31.0 vs. 28.2%; p = 0.014) and periventricular leukomalacia (PVL, 3.7 vs. 2.5%, p = 0.004). In a multivariate logistic regression model, birth during influenza season was associated with PVL [odds ratio (OR) 1.47 (1.11-1.95), p = 0.007] and clinical sepsis [OR 1.13 (1.01-1.27), p = 0.036], independent of known risk factors, i.e., gestational age, multiple birth, gender, and small for gestational age. The risk for bronchopulmonary dysplasia was not influenced by influenza seasonality. In the small subgroup with information on 24 months follow-up (n = 1497), an increased incidence of common cold and bronchitis episodes was noted in infants born during influenza season.Conclusion: Our observational data indicate that preterm birth during influenza season is associated with PVL and sepsis. These are novel aspects that deserve further investigations to address underlying causes and to include virus surveillance.