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Master Thesis

Bronchiolites du prématuré tardif et du grand prématuré : incidence, facteurs de risque

Abstract : Objective:Preterm infants are at higher risk of RSV bronchiolitis that increases respiratory morbidity, and persistent wheezing, decreases lung function and alteres quality of life. Palivizumab, a monoclonal antibody, can be used for prophylaxis against RSV infection in children at high risk. However, there is no clear recommendation on its indications in moderate-late preterm (MLP) infants. Those born after 32 wGA do not receive Palivizumab treatment in the University Hospital of Grenoble. The objective of this study was to analyse the prevalence and factors associated with bronchiolitis in very preterm (VP) infants (30-31+6 GA), and in MLP infants (32-34+6 GA) in the University Hospital of Grenoble.Methods:This observational retrospective study included preterm infants born between 30 wGA and 34+6 wGA from the follow-up organisation “Naitre et Devenir” from 1st January 2014 to 31st December 2015. Collected data were neonatal and environmental background, diagnosis of bronchiolitis and treatment with Palivizumab. Data were obtained from hospitalisation and pharmacy reports, medical file and infants follow-up records of “Naitre et Devenir”.The primary outcome was the prevalence of bronchiolitis among groups, during the first year after discharge.The secondary outcomes were to determine risk factors of bronchiolitis in preterm infants.Results:A total of 346 children were enrolled, 72 in the VP group and 274 in the MLP group. VP group was characterized by more frequent bronchopulmonary dysplasia, more frequent use of surfactant and more frequent intubation in early life, while MLP group had a higher community attendance. The prevalence of bronchiolitis during the first year of life was 19% (n=14/72) in VP group and 31% (n=85/274) in MLP group (p=0,05). Hospitalisation rate was 86% in VP group and 60% in MLP group (p=0,064). Exclusive breast feeding in VP infants was associated with a significantly lower prevalence of bronchiolitis in VP group (50% vs 14%, p=0,01). Long term non-invasive ventilation in the early life is associated with more frequent bronchiolitis in MLP (6% vs 1%, p=0,03).Conclusions:Our results suggest that MLP infants have a high prevalence of bronchiolitis. A program of prevention of bronchiolitis in this population, including Palivizumab prophylaxis should be evaluated.
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Master Thesis
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Submitted on : Monday, April 1, 2019 - 12:05:56 PM
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  • HAL Id : dumas-02086330, version 1


Marie Simone Henriette Martinod. Bronchiolites du prématuré tardif et du grand prématuré : incidence, facteurs de risque. Médecine humaine et pathologie. 2019. ⟨dumas-02086330⟩



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