Background
Methods
Study design
Study outcomes
Predictors
Attrition
Data collection
Statistical analyses
Results
Study participants
Gestational age, wk | ||||||
---|---|---|---|---|---|---|
32–33
|
34–36
|
37
|
38–40
|
≥ 41
|
All gestational ages
| |
N | 936 | 4,665 | 4582 | 51,049 | 11,370 | 72,602 |
Male sex, % | 51.07 | 54.81 | 53.40 | 50.44 | 50.71 | 50.96 |
Race, %* | ||||||
White | 46.79 | 43.09 | 39.90 | 42.87 | 47.65 | 43.50 |
African-American | 11.32 | 10.40 | 9.41 | 8.57 | 9.30 | 8.89 |
Asian | 16.35 | 19.85 | 23.42 | 20.74 | 15.27 | 19.94 |
Hispanic | 16.99 | 18.93 | 20.32 | 21.25 | 20.81 | 20.92 |
Other/unknown | 8.55 | 7.74 | 6.96 | 6.56 | 6.97 | 6.75 |
Maternal age, y, % | ||||||
<18 | 2.24 | 1.29 | 1.18 | 1.19 | 1.49 | 1.25 |
18–34 | 67.20 | 68.75 | 70.76 | 73.58 | 74.64 | 73.17 |
>35 | 30.56 | 29.97 | 28.07 | 25.23 | 23.87 | 25.57 |
Family history of asthma, %†
| ||||||
None | 93.91 | 94.23 | 94.43 | 94.82 | 95.15 | 94.80 |
Father only | 2.03 | 1.63 | 1.66 | 1.49 | 1.37 | 1.50 |
Mother only | 4.06 | 4.14 | 3.84 | 3.60 | 3.42 | 3.63 |
Both parents | 0.00 | 0.00 | 0.07 | 0.09 | 0.06 | 0.08 |
31 sibling <5 y of age in home, % | 42.95 | 42.17 | 39.57 | 39.51 | 32.22 | 38.58 |
Congenital anomaly present, %‡
| 13.14 | 10.33 | 7.77 | 6.52 | 6.24 | 6.88 |
Small for gestational age, %§
| 4.59 | 3.41 | 2.23 | 1.25 | 0.67 | 1.40 |
Oxygen exposure|| and BPD, %¶
| ||||||
No oxygen, no BPD | 55.77 | 86.13 | 96.49 | 97.77 | 96.31 | 96.17 |
<200 hours oxygen, no BPD | 37.50 | 12.24 | 3.12 | 1.95 | 3.26 | 3.35 |
3200 hours oxygen, no BPD | 5.24 | 1.29 | 0.37 | 0.25 | 0.40 | 0.41 |
BPD | 1.50 | 0.34 | 0.02 | 0.03 | 0.04 | 0.07 |
Unspecified respiratory hospitalization %#
| 15.92 | 15.05 | 12.40 | 8.09 | 7.19 | 8.77 |
Laboratory-confirmed, medically attended RSV infection, %** | 3.95 | 2.98 | 2.14 | 1.64 | 1.36 | 1.74 |
Admitted to hospital, %‡‡
| 2.46 | 1.31 | 0.87 | 0.63 | 0.49 | 0.69 |
Treated as outpatient, %§§
| 1.50 | 1.67 | 1.27 | 1.00 | 0.87 | 1.05 |
Laboratory-confirmed, medically attended infection with other pathogen, %††
| 0.64 | 0.58 | 0.31 | 0.28 | 0.25 | 0.30 |
Admitted to hospital, %‡‡
| 0.53 | 0.28 | 0.13 | 0.13 | 0.11 | 0.14 |
Treated as outpatient, %§§
| 0.11 | 0.3 | 0.17 | 0.16 | 0.14 | 0.16 |
RSV infection and the prevalence of recurrent wheezing
Beta | Adjusted odds ratio | 95% CI |
PValue | |
---|---|---|---|---|
Sex | ||||
Male | 0.40 | 1.49 | 1.39–1.60 | <.0001 |
Female |
reference
| |||
Race†
| ||||
White |
reference
| |||
African-American | 0.53 | 1.71 | 1.52–1.91 | <.0001 |
Asian | 0.31 | 1.36 | 1.24–1.49 | <.0001 |
Hispanic | 0.10 | 1.11 | 1.01–1.22 | 0.0356 |
Other/unknown | 0.22 | 1.25 | 1.09–1.44 | 0.0020 |
Maternal age, y | ||||
<18 | -0.07 | 0.94 | 0.69–1.28 | 0.6764 |
18–34 |
reference
| |||
≥35 | 0.04 | 1.04 | 0.96–1.13 | 0.3321 |
Family history of asthma†
| ||||
Unknown |
reference
| |||
Father only | 0.59 | 1.81 | 1.44–2.27 | <.0001 |
Mother only | 0.76 | 2.15 | 1.87–2.47 | <.0001 |
Both parents | 0.53 | 1.70 | 0.61–4.71 | 0.3109 |
Siblings <5 y of age in house | ||||
None |
reference
| |||
≥1 | -0.15 | 0.86 | 0.80–0.92 | <.0001 |
Congenital anomaly†
| ||||
Present | 0.13 | 1.14 | 1.00-1.29 | 0.0493 |
Absent |
reference
| |||
Small for gestational age†
| ||||
No |
reference
| |||
Yes | -0.04 | 0.96 | 0.72–1.28 | 0.7822 |
Gestational age, wk | ||||
32–33 | 0.40 | 1.49 | 1.15–1.92 | 0.0022 |
34–36 | 0.26 | 1.30 | 1.14–1.48 | <.0001 |
37 | 0.11 | 1.12 | 0.98–1.29 | 0.1049 |
38–40 |
reference
| |||
≥41 | -0.06 | 0.95 | 0.85–1.05 | 0.2717 |
Oxygen exposure and BPD†
| ||||
No oxygen exposure, no BPD |
reference
| |||
<200 hours oxygen, no BPD | 0.28 | 1.32 | 1.12–1.57 | 0.0012 |
≥200 hours oxygen, no BPD | 0.69 | 2.00 | 1.37–2.90 | 0.0003 |
BPD | 1.03 | 2.80 | 1.31–5.98 | 0.0078 |
Unspecified respiratory hospitalization†
| ||||
None |
reference
| |||
Uncomplicated hospitalization | 0.50 | 1.65 | 0.98–2.79 | 0.0594 |
Prolonged hospitalization | 1.24 | 3.46 | 1.94–6.16 | <.0001 |
Laboratory-confirmed, medically attended RSV infection†
| ||||
None |
reference
| |||
Outpatient visit only | 0.32 | 1.38 | 1.03–1.85 | 0.0307 |
Uncomplicated hospitalization | 0.68 | 1.98 | 1.39–2.81 | 0.0002 |
Prolonged hospitalization | 0.95 | 2.59 | 1.49–4.50 | 0.0007 |
Laboratory-confirmed, medically attended infection with other pathogen†
| ||||
None |
reference
| |||
Outpatient visit only | 0.26 | 1.30 | 0.62–0.69 | 0.4883 |
Uncomplicated hospitalization | 0.32 | 1.38 | 0.54–3.52 | 0.4981 |
Prolonged hospitalization | 0.74 | 2.10 | 0.76–5.80 | 0.1526 |
RW 2nd Year | RW 3rd Year | RW 4th Year | RW 5th Year | RW 2nd–5th Years | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
N | n | % | n | % | n | % | n | % | n | % | |
All children | 72,602 | 4,091 | 5.6 | 3,492 | 4.8 | 3,466 | 4.8 | 3,380 | 4.7 | 9,151 | 12.6 |
Sex | |||||||||||
Female | 35,606 | 1,402 | 3.9 | 1,261 | 3.5 | 1,318 | 3.7 | 1,330 | 3.7 | 3,499 | 9.8 |
Male | 36,996 | 2,689 | 7.3 | 2,231 | 6.0 | 2,148 | 5.8 | 2,050 | 5.5 | 5,652 | 15.3 |
Race* | |||||||||||
White | 31,580 | 1,650 | 5.2 | 1,443 | 4.6 | 1,353 | 4.3 | 1,265 | 4.0 | 3,642 | 11.5 |
African-American | 6,454 | 517 | 8.0 | 409 | 6.3 | 420 | 6.5 | 441 | 6.8 | 1,093 | 16.9 |
Asian | 14,476 | 807 | 5.6 | 774 | 5.3 | 785 | 5.4 | 764 | 5.3 | 1,983 | 13.7 |
Hispanic | 15,189 | 876 | 5.8 | 644 | 4.2 | 670 | 4.4 | 664 | 4.4 | 1841 | 12.1 |
Other/unknown | 4,903 | 241 | 4.9 | 222 | 4.5 | 238 | 4.9 | 246 | 5.0 | 592 | 12.1 |
Maternal age, y | |||||||||||
<18 | 911 | 55 | 6.0 | 38 | 4.2 | 37 | 4.1 | 44 | 4.8 | 118 | 13.0 |
18–34 | 53,125 | 3,068 | 5.8 | 2,530 | 4.8 | 2,571 | 4.8 | 2,453 | 4.6 | 6,779 | 12.8 |
≥35 | 18,566 | 968 | 5.2 | 924 | 5.0 | 858 | 4.6 | 883 | 4.8 | 2,254 | 12.1 |
Family history of asthma* | |||||||||||
None | 68,824 | 3,698 | 5.4 | 3,131 | 4.5 | 3,135 | 4.6 | 3,053 | 4.4 | 8,320 | 12.1 |
Father only | 1,087 | 91 | 8.4 | 94 | 8.6 | 92 | 8.5 | 83 | 7.6 | 220 | 20.2 |
Mother only | 2,633 | 294 | 11.2 | 258 | 9.8 | 232 | 8.8 | 240 | 9.1 | 596 | 22.6 |
Both parents | 58 | 8 | 13.8 | 9 | 15.5 | 7 | 12.1 | 4 | 6.9 | 15 | 25.9 |
Sibling aged <5 y in home | |||||||||||
None | 44,590 | 2,358 | 5.3 | 2,127 | 4.8 | 2,246 | 5.0 | 2,197 | 4.9 | 5,631 | 12.6 |
≥1 | 28,012 | 1,733 | 6.2 | 1,365 | 4.9 | 1,220 | 4.4 | 1,183 | 4.2 | 3,520 | 12.6 |
Congenital anomaly* | |||||||||||
Absent | 67,605 | 3,739 | 5.5 | 3,176 | 4.7 | 3,170 | 4.7 | 3,079 | 4.6 | 8,371 | 12.4 |
Present | 4,997 | 352 | 7.0 | 316 | 6.3 | 296 | 5.9 | 301 | 6.0 | 780 | 15.6 |
Small for gestational age* | |||||||||||
No | 71,582 | 4,011 | 5.6 | 3,424 | 4.8 | 3,405 | 4.8 | 3,328 | 4.6 | 8,989 | 12.6 |
Yes | 1020 | 80 | 7.8 | 68 | 6.7 | 61 | 6.0 | 52 | 5.1 | 162 | 15.9 |
Gestational age, wk* | |||||||||||
32–33 | 936 | 99 | 10.6 | 81 | 8.7 | 78 | 8.3 | 75 | 8.0 | 188 | 20.1 |
34-36 | 4,665 | 401 | 8.6 | 290 | 6.2 | 294 | 6.3 | 294 | 6.3 | 793 | 17.0 |
37 | 4,582 | 270 | 5.9 | 264 | 5.8 | 209 | 4.6 | 238 | 5.2 | 635 | 13.9 |
38–40 | 51,049 | 2,763 | 5.4 | 2,373 | 4.6 | 2,345 | 4.6 | 2,290 | 4.5 | 6,235 | 12.2 |
≥41 | 11,370 | 558 | 4.9 | 484 | 4.3 | 540 | 4.7 | 483 | 4.2 | 1,300 | 11.4 |
Oxygen exposure* and BPD* | |||||||||||
No oxygen, no BPD | 6,9821 | 3,819 | 5.5 | 3,267 | 4.7 | 3,249 | 4.7 | 3,162 | 4.5 | 8,607 | 12.3 |
<200 h Oxygen, no BPD | 2,431 | 221 | 9.1 | 177 | 7.3 | 165 | 6.8 | 173 | 7.1 | 445 | 18.3 |
≥200 h Oxygen, no BPD | 300 | 43 | 14.3 | 34 | 11.3 | 45 | 15.0 | 36 | 12.0 | 80 | 26.7 |
BPD | 50 | 8 | 16.0 | 14 | 28.0 | 7 | 14.0 | 9 | 18.0 | 19 | 38.0 |
Unspecified respiratory hospitalization* | |||||||||||
None | 72,345 | 4017 | 5.6 | 3,449 | 4.8 | 3,420 | 4.7 | 3,348 | 4.6 | 9,052 | 12.5 |
Uncomplicated hospitalization | 177 | 47 | 26.6 | 24 | 13.6 | 26 | 14.7 | 16 | 9.0 | 64 | 36.2 |
Prolonged hospitalization | 80 | 27 | 33.8 | 19 | 23.8 | 20 | 25.0 | 16 | 20.0 | 35 | 43.8 |
Laboratory-confirmed, medically attended RSV infection* | |||||||||||
None | 71,336 | 3,829 | 5.4 | 3,326 | 4.7 | 3,312 | 4.6 | 3,280 | 4.6 | 8,748 | 12.3 |
Outpatient | 762 | 127 | 16.7 | 79 | 10.4 | 74 | 9.7 | 50 | 6.6 | 201 | 26.4 |
Uncomplicated hospitalization | 384 | 105 | 27.3 | 67 | 17.4 | 57 | 14.8 | 35 | 9.1 | 154 | 40.1 |
Prolonged hospitalization | 120 | 30 | 25.0 | 20 | 16.7 | 23 | 19.2 | 15 | 12.5 | 48 | 40.0 |
Laboratory-confirmed, medically attended infection with other pathogen* | |||||||||||
None | 72,382 | 4,056 | 5.6 | 3,476 | 4.8 | 3,449 | 4.8 | 3,362 | 4.6 | 9,101 | 12.6 |
Outpatient | 119 | 20 | 16.8 | 7 | 5.9 | 7 | 5.9 | 8 | 6.7 | 30 | 25.2 |
Uncomplicated hospitalization | 64 | 7 | 10.9 | 3 | 4.7 | 5 | 7.8 | 5 | 7.8 | 10 | 15.6 |
Prolonged hospitalization | 37 | 8 | 21.6 | 6 | 16.2 | 5 | 13.5 | 5 | 13.5 | 10 | 27.0 |
Definite, medically attended RSV encounter in the first year of life* | |||||||||||
No | 71,336 | 3,829 | 5.4 | 3,326 | 4.7 | 3,312 | 4.6 | 3,280 | 4.6 | 8,748 | 12.3 |
Yes | 1,266 | 262 | 20.7 | 166 | 13.1 | 154 | 12.2 | 100 | 7.9 | 403 | 31.8 |