Environmental exposures and respiratory morbidity among very low birth weight infants at 1 year of life.
BACKGROUND
Preterm infants have a substantially increased risk of developing respiratory illnesses. The goal of this study was to consider the impact of modifiable postnatal exposures on respiratory morbidity among a cohort of very low birth weight (VLBW) infants.


OBJECTIVE
(1) Assess the rates of respiratory morbidity and exposure to indoor respiratory triggers in a population of VLBW infants at 1 year; (2) determine the association between exposures and respiratory morbidity.


METHODS
We enrolled 124 VLBW infants into a prospective cohort study. Parents were called at 1 year to assess respiratory outcomes and environmental exposures. We used bivariate and multivariate analyses to assess the relationship between environmental exposures and acute care for respiratory illnesses.


RESULTS
At 1 year, 9% of infants had physician-diagnosed asthma, 47% required >or=1 acute visit and 11% required hospitalisation for respiratory illness. The majority of infants (82%) were exposed to at least one indoor respiratory trigger. Infants living with a smoker (61% vs 40%) and infants exposed to pests (62% vs 39%) were more likely than unexposed infants to require acute care for respiratory problems. In a multivariate regression controlling for demographics, birth weight, bronchopulmonary dysplasia, and family history of asthma or allergies, both living with a smoker (OR 2.62; CI 1.09 to 6.29) and exposure to pests (OR 4.41; CI 1.22 to 15.94) were independently associated with the need for acute care for respiratory illnesses.


CONCLUSIONS
In this sample, respiratory morbidity and exposure to triggers were common. VLBW infants may benefit from interventions that decrease exposure to respiratory triggers.
Halterman
J S
JS
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. jill_halterman@urmc.rochester.edu
Lynch
K A
KA
Conn
K M
KM
Hernandez
T E
TE
Perry
T T
TT
Stevens
T P
TP
D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001249:Asthma / Q000209:etiology* / Q000517:prevention & control; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D015999:Multivariate Analysis; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000502:physiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*