Frequency, Burden and Pathogens of Acute Respiratory Illness in Very Preterm Infants During Infancy
In brief
Every very preterm infant suffers at least one respiratory illness in the first year
In a prospective cohort of 89 very preterm infants, 100% experienced an acute respiratory illness during the first year after NICU discharge, with rhinovirus detected in nearly half of illness episodes and RSV driving most hospital visits. Male infants and those discharged in summer faced higher rates of wheezy lower-tract disease, hospitalisation and asthma medication use, underscoring the need for better preventive strategies.
- Journal
- Acta paediatrica (Oslo, Norway : 1992) (Q1)
- Published
- 28 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Patricia De Gouveia Belinelo, Nada Townsi, Naomi R Hemy, Chisha T Sikazwe, David W Smith, Benjamin Stoecklin, et al.
- PMID
- 42665881
- DOI
- 10.1111/apa.70731
Why clinicians should know about it
- Picked for Neonatology (paper of the day, 1 September 2026): Very preterm infants ARI frequency and pathogens
Abstract
AIM: To describe the frequency, burden, and pathogen profile of acute respiratory illnesses (ARIs) in very preterm infants during the first year after neonatal intensive care unit (NICU) discharge. METHODS: Very preterm infants were followed prospectively (August 2015-January 2017) with monthly assessments of symptoms, medication use, and healthcare utilisation. Parent-reported ARIs triggered additional clinical follow-up. Nasal swabs were collected monthly and during ARIs and tested for respiratory pathogens using real-time PCR. RESULTS: Of 125 eligible infants, 99 (79.2%) were enrolled, and 89 completed the 12-month follow-up. All infants experienced at least one ARI during the first year. Male sex was associated with increased risk of wheezy lower respiratory tract illness (LRTI) (RR 1.61), hospitalisation (RR 3.89), and asthma medication use (RR 5.89). NICU discharge during summer was associated with higher ARI rates (RR 1.33) and hospitalisation (RR 2.54). Rhinovirus was most frequently detected (13.5% of monthly swabs; 43.8% of ARI swabs), whereas respiratory syncytial predominated in emergency department presentations and hospital admissions (18.8% and 20.0%, respectively). CONCLUSIONS: Very preterm infants experienced substantial respiratory morbidity during the first year after NICU discharge. These findings highlight the need for improved preventive and post-discharge strategies in this high-risk population.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.