TY - JOUR
T1 - Short-and long-term pulmonary outcome of palivizumab in children born extremely prematurely
AU - Prais, Dario
AU - Kaplan, Eytan
AU - Klinger, Gil
AU - Mussaffi, Huda
AU - Mei-Zahav, Meir
AU - Bar-Yishay, Ephraim
AU - Stafler, Patrick
AU - Steuer, Guy
AU - Sirota, Lea
AU - Blau, Hannah
N1 - Publisher Copyright:
© 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
PY - 2016/3
Y1 - 2016/3
N2 - 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. CONCLUSION: 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.
AB - 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. CONCLUSION: 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.
KW - Bronchopulmonary dysplasia
KW - Pulmonary function test
KW - Respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=84960333462&partnerID=8YFLogxK
U2 - 10.1378/chest.15-0328
DO - 10.1378/chest.15-0328
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AN - SCOPUS:84960333462
SN - 0012-3692
VL - 149
SP - 801
EP - 808
JO - Chest
JF - Chest
IS - 3
ER -