title: Short- and Long-term Pulmonary Outcome of Palivizumab in Children Born Extremely Prematurely.
abstract: BACKGROUND
  Palivizumab reduces the severity of respiratory syncytial virus infection in premature infants, but whether there is a protective effect beyond the preschool age is unknown. This study sought to assess the short- and long-term effects of palivizumab immunization on respiratory morbidity and pulmonary function at school age in children born extremely prematurely.
  
  
  METHODS
  Infants born before 29 weeks' gestation in 2000 to 2003 were assessed at school age by parental questionnaire, hospital chart review, and lung function tests. Children born immediately before the introduction of routine palivizumab prophylaxis were compared with age-matched children who received palivizumab prophylaxis during the first respiratory syncytial virus season.
  
  
  RESULTS
  Sixty-three children with a mean age 8.9 years were included: 30 had received palivizumab and 33 had not (control subjects). The groups were similar in terms of gestational age, birth weight, need for mechanical ventilation, and oxygen supplementation. Fifty-three percent of the palivizumab group, compared with 39% of the control group, had bronchopulmonary dysplasia (P = .14). Wheezing occurred in the first 2 years of life in 27% of the palivizumab group and in 70% of control subjects (P = .008); respective hospitalization rates were 33% and 70% (P = .001). At school age, rates of hyperresponsiveness (provocative concentration leading to a 20% fall in FEV1 < 1 mg/mL) were 33% and 48%, respectively (P = .38). Spirometry, lung volumes, diffusion, and exhaled nitric oxide were within normal limits, with no significant differences between groups.
  
  
  CONCLUSIONS
  Palivizumab prophylaxis was associated with reduced wheezing episodes and hospitalizations during the first 2 years of life in children born extremely prematurely. However, it did not affect pulmonary outcome at school age.
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: prais@post.tau.ac.il.
authors.forename: Dario
authors.initials: D
authors.lastname: Prais
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eytan
authors.initials: E
authors.lastname: Kaplan
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Huda
authors.initials: H
authors.lastname: Mussaffi
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Mei-Zahav
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel.
authors.forename: Ephraim
authors.initials: E
authors.lastname: Bar-Yishay
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Patrick
authors.initials: P
authors.lastname: Stafler
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Steuer
authors.affiliation: Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Lea
authors.initials: L
authors.lastname: Sirota
authors.affiliation: Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D018890:Chemoprevention; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D062071:Infant, Extremely Premature; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D000069455:Palivizumab / Q000627:therapeutic use*; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity; D018357:Respiratory Syncytial Virus Infections / Q000503:physiopathology / Q000517:prevention & control*; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000503:physiopathology / Q000517:prevention & control*; D012621:Seasons; D012720:Severity of Illness Index; D013147:Spirometry
chemical_list: D000998:Antiviral Agents; D000069455:Palivizumab
keywords: bronchopulmonary dysplasia; pulmonary function test; respiratory syncytial virus