Dataset Information

Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants.

ABSTRACT:

Objective

We investigated the relationship between influenza seasonality and outcome of very low birth weight infants (VLBWI) in a large observational cohort study of the German Neonatal Network.

Materials and methods

Within the observational period (July 2009 until December 2014), five influenza seasons occurred (mean duration: 97?days, range: 48-131?days). We stratified VLBWI (n?=?10,187) according to date of birth into three categories: (1)?before influenza season, (2) during influenza season, and (3) 3?months after the end of the respective season. Outcomes were assessed in univariate and logistic regression analyses. In a subgroup of infants (n?=?1497), the number of respiratory infections during the first 24?months of life was assessed.

Results

VLBWI born during influenza season carried a higher risk for clinical sepsis (31.0 vs. 28.2%; p?=?0.014) and periventricular leukomalacia (PVL, 3.7 vs. 2.5%, p?=?0.004). In a multivariate logistic regression model, birth during influenza season was associated with PVL [odds ratio (OR) 1.47 (1.11-1.95), p?=?0.007] and clinical sepsis [OR 1.13 (1.01-1.27), p?=?0.036], independent of known risk factors, i.e., gestational age, multiple birth, gender, and small for gestational age. The risk for bronchopulmonary dysplasia was not influenced by influenza seasonality. In the small subgroup with information on 24?months follow-up (n?=?1497), an increased incidence of common cold and bronchitis episodes was noted in infants born during influenza season.

Conclusion

Our observational data indicate that preterm birth during influenza season is associated with PVL and sepsis. These are novel aspects that deserve further investigations to address underlying causes and to include virus surveillance.

SUBMITTER: Hartel C

PROVIDER: S-EPMC5129678 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants.

Härtel Christoph C Humberg Alexander A Viemann Dorothee D Stein Anja A Orlikowsky Thorsten T Rupp Jan J Kopp Matthias V MV Herting Egbert E Göpel Wolfgang W

Frontiers in pediatrics 20161130

<h4>Objective</h4>We investigated the relationship between influenza seasonality and outcome of very low birth weight infants (VLBWI) in a large observational cohort study of the German Neonatal Network.<h4>Materials and methods</h4>Within the observational period (July 2009 until December 2014), five influenza seasons occurred (mean duration: 97 days, range: 48-131 days). We stratified VLBWI (<i>n</i> = 10,187) according to date of birth into three categories: (1) before influenza season, (2) d ...[more]

PMID: 27965950

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Project description:ImportanceReduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine.ObjectiveTo assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low-birth-weight infants.Design, setting, and participantsA retrospective cohort analysis was conducted of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 through 2009 and evaluated at 18 to 22 months' corrected age. Twenty-two academic neonatal intensive care units participated. Inclusion criteria were birth weight 401 to 1500 g, survival to 12 hours, and availability for follow-up. A total of 12 111 infants were included in analyses.ExposuresSurgical procedures; surgery also was classified by expected anesthesia type as major (general anesthesia) or minor (nongeneral anesthesia).Main outcomes and measuresMultivariable logistic regression analyses planned a priori were performed for the primary outcome of death or neurodevelopmental impairment and for the secondary outcome of neurodevelopmental impairment among survivors. Multivariable linear regression analyses were performed as planned for the adjusted mean scores of the Mental Developmental Index and Psychomotor Developmental Index of the Bayley Scales of Infant Development, Second Edition, for patients born before 2006.ResultsA total of 2186 infants underwent major surgery, 784 had minor surgery, and 9141 infants did not undergo surgery. The risk-adjusted odds ratio of death or neurodevelopmental impairment for all surgery patients compared with those who had no surgery was 1.29 (95% CI, 1.08-1.55). For patients who had major surgery compared with those who had no surgery, the risk-adjusted odds ratio of death or neurodevelopmental impairment was 1.52 (95% CI, 1.24-1.87). Patients classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who had no surgery, the adjusted risk of neurodevelopmental impairment was greater and the adjusted mean Bayley scores were lower.Conclusions and relevanceMajor surgery in very low-birth-weight infants is independently associated with a greater than 50% increased risk of death or neurodevelopmental impairment and of neurodevelopmental impairment at 18 to 22 months' corrected age. The role of general anesthesia is implicated but remains unproven.

Project description:ObjectivesThe aim of the present study was to examine the changes in bacteria in hospitalized preterm infants during the first month of life.MethodsRectal swabs were collected daily from 12 preterm infants. DNA was extracted from swabs from day of birth and weekly thereafter. Bacterial taxa were identified with next generation sequencing using universal bacterial primers targeted at the 16S ribosomal DNA on a 454 Roche titanium platform. Sequences were clustered into operational taxonomic units, and taxonomy was assigned against the Greengenes databank using Quantitative Insights Into Microbial Ecology version 1.4. Quantitative polymerase chain reaction was used to determine the abundance of Bifidobacterium spp. Functional assessment of the microbiome was performed with Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt).ResultsAverage birth weight and gestational age were 1055 g and 28 weeks, respectively. There were 6 to 35 different bacterial families identified in the day-of-birth samples, unrelated to the mode of delivery. Richness decreased through hospitalization (week 1, 16.9 ± 7.7 vs weeks 3-5, 10.7 ± 3.4, P < 0.001). The Shannon diversity index demonstrated the lowest diversity at birth, an increase at week 2, followed by a rapid decline at weeks 3 to 5, suggesting the development of a more uniform microbiota composition after 2 weeks of stay at a neonatal intensive care unit. Enterobacteriaceae, Staphylococcaceae, and Enterococcaceae constituted the majority of the bacterial families. Bifidobacterium spp were infrequently detected at extremely low levels. PICRUSt analysis revealed the enhancement of peroxisome, PPAR, and adipocytokine signaling; plant-pathogen interaction; and aminobenzoate degradation pathways in week 1 samples.ConclusionsOur results suggest that although preterm infants have individualized microbiota that are detectable at birth, the differences decrease during the neonatal intensive care unit hospitalization with increasing prominence of pathogenic microbiota.

Dataset Information

Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants.

Objective

Materials and methods

Results

Conclusion

Publications

Preterm Birth during Influenza Season Is Associated with Adverse Outcome in Very Low Birth Weight Infants.

Similar Datasets

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