Preterm twins and triplets. A high-risk group for severe respiratory syncytial virus infection.
OBJECTIVE
To assess the impact of multiple births and crowded homes on the severity of respiratory syncytial virus illness in preterm infants with bronchopulmonary dysplasia.


METHODS
Retrospective case-control chart review from a prospective longitudinal respiratory illness study.


METHODS
Neonatal High-Risk Follow-Up Clinic (outpatient setting) and tertiary care hospitals (inpatient setting).


METHODS
Fourteen sets of twins and two sets of triplets followed up between 1983 and 1989 and matched with 34 singleton infants for date of birth (within 3 months) and gestational age (within 1 month).


RESULTS
The risk of developing respiratory syncytial virus illness was significantly higher in multiple-birth infants than in singletons (53% vs 24%; P = .01). Multiple-birth infants were also at greater risk for developing pneumonia (24% vs 6%; P = .05) and requiring hospitalization (32% vs 18%; P = .05) than were singletons. Additional risk factors for developing pneumonia and bronchiolitis were examined in all 68 children. Multiple birth (P = .05), gestational age of less than 30 weeks (P = .02), and crowded homes (defined as more than one person living in 19 m2 of living space [P = .002] or more than one child living in 22 m2 of living space [P = .004]) were additional risk factors for developing pneumonia.


CONCLUSIONS
Multiple-birth preterm infants are at a higher risk of developing pneumonia than are singletons. Additional risk factors for developing pneumonia in preterm infants with bronchopulmonary dysplasia include gestational age of less than 30 weeks and crowded homes. At-risk infants with any of these risk factors should be targeted for prophylactic and therapeutic interventions against respiratory syncytial virus.
Simoes
E A
EA
Department of Pediatrics, University of Colorado School of Medicine, Denver.
King
S J
SJ
Lehr
M V
MV
Groothuis
J R
JR
D001724:Birth Weight; D001988:Bronchiolitis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D003120:Colorado / Q000453:epidemiology; D003441:Crowding; D004200:Diseases in Twins / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D044469:Racial Groups; D012136:Respiratory Syncytial Viruses; D010253:Respirovirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012720:Severity of Illness Index; D014310:Triplets