[Respiratory diseases in infants hospitalized during the 1st 2 years of life for viral lower respiratory tract infections: a one-year follow-up].
BACKGROUND
Epidemiologic data suggest strong links between hospitalisation with bronchiolitis in infancy and subsequent higher risk of developing lower respiratory tract infections (LRTI) and/or hyperreactive airway diseases. The aim of this study was to evaluate in an Italian population the natural history of respiratory diseases in children hospitalised for LRTI when they were <2 years.


METHODS
An observational, perspective, longitudinal study was performed through telephone interviews. Nine pediatric tertiary care centres participated to the study evaluating a population of 187 children, hospitalised in the previous year (November 1999-April 2000) for bronchiolitis or pneumonia when they were <2 years of age and participated to a previous study on the prevalence of infant LRTI in Italy (RADAR).


RESULTS
Twenty-three (12.3%) children had a gestational age <36 weeks. In the 12 months following the first hospitalisation, an elevated frequency of respiratory symptoms was found. Indeed, 152 (81.3%) children suffered from not-requiring-hospital-admission respiratory infections and 21 (11.2%) were hospitalized again for LRTI: 11.6% had bronchiolitis, 23.5% bronchitis and 35.2% pneumonia. In addition, 1.2% had gs;3 infectious episodes and 21.4% gs;6: 68 (36.4%) showed wheezy bronchitis and 17 (9.1%) were reported to have asthma; 132 children (71%) took antibiotics during the last year, 19.4% >3 times; 111 (59.4%) bronchodilators and 49 (26.2%) oral corticosteroids. One year after the first hospitalisation, 19 subjects (10.2%) were found to be positive to at least one class of allergens by prick test or RAST.


CONCLUSIONS
Thus, the demonstration of a high morbidity rate for LRTI, wheezing and asthma in this study group during the first year follow-up after hospital admission further support the need for prophylactic interventions to reduce the morbidity and severity of sequelae of LRTI, in particularly in premature children and/or with additional risk factors.
Giovannini
M
M
Clinica Pediatrica Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.
Rossi
G A
GA
Merolla
R
R
Arena
F
F
Cutrera
R
R
Dalla Casa
P
P
D'Andrea
N
N
Galluzzo
C
C
Indinnimeo
L
L
Ivaldi
M
M
Pifferi
M
M
Rinaldi
G
G
Torcoletti
M
M
Zuccotti
G V
GV
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology*; D001991:Bronchitis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D011024:Pneumonia, Viral / Q000453:epidemiology*; D011446:Prospective Studies; D012135:Respiratory Sounds; D019141:Respiratory System Agents / Q000627:therapeutic use; D012307:Risk Factors; D014777:Virus Diseases / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D019141:Respiratory System Agents