Infants who are hospitalized for bronchiolitis have a significantly increased risk of subsequent hospital admissions for asthma, wheezing, and respiratory infections, according to results published in the Archives of Diseases in Childhood.

The study included infants born between April 1, 2007, and March 21, 2008, who were followed until they reached age 5 years, using Hospital Episode Statistics admissions data (n=613,377). The researchers used Cox proportional hazard regression to compare the risk for respiratory hospital admission resulting from asthma, wheezing, and lower and upper respiratory tract infections among infants who had been admitted for bronchiolitis and those who had not. They calculated hazard ratios (HRs), adjusting for known respiratory illness risk factors, including living in deprived households and being born preterm or with a comorbid condition.

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Overall, 2.7% (n=16,288) of the infants had at least 1 admission for bronchiolitis. Of these, 21.7% had another respiratory hospital admission by age 5 years compared with 8% of infants who did not have a previous bronchiolitis admission (adjusted HR [aHR], 2.82; 95% CI, 2.72-2.92).

The results indicated that the association between initial admission for bronchiolitis and another respiratory hospital admission was strongest for asthma (aHR, 4.35; 95% CI, 4.00-4.73) and wheezing (aHR, 5.02; 95% CI, 4.64-5.44). The researchers also found significant associations for upper and lower respiratory tract infections admissions (aHR, 2.34 [95% CI, 2.23-2.45] and aHR, 3.10 [95% CI, 2.91-3.31], respectively).

“This highlights substantial potential benefits from vaccine development to reduce the childhood health burden caused by [respiratory syncytial virus],” the researchers wrote.

Reference

Skirrow H, Wincott T, Cecil E, et al. Preschool respiratory hospital admissions following infant bronchiolitis: a birth cohort study [published online March 6, 2019]. Arch Dis Child. doi:10.1136/archdischild-2018-316317