Preterm Infants at Higher Risk for RSV Hospitalization Following 2014 Guidance

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Specifically, there was a 2.5–5 times higher risk for preterm infants <6 months old to be hospitalized than full-term infants in 2014–2015. <i>Photo Credit: CDC/ Dr H. Craig Lyerla.</i>
Specifically, there was a 2.5–5 times higher risk for preterm infants <6 months old to be hospitalized than full-term infants in 2014–2015. Photo Credit: CDC/ Dr H. Craig Lyerla.

AstraZeneca announced new data showing a higher risk of respiratory syncytial virus (RSV) hospitalization for preterm infants during the 2015–2016 season vs data from the previous season. The findings were presented at the Academy of Managed Care Pharmacy (AMCP) Nexus Meeting, in Dallas, Texas.

This was the first US analysis to investigate serious RSV disease in preterm infants from the 2 seasons after a 2014 guidance issued by the American Academy of Pediatrics (AAP) recommended against the use of RSV immunoprophylaxis in infants born 29–34 weeks gestational age. The guidance had stated that infants born 29–34 weeks gestational age did not have a significantly higher risk of RSV hospitalization vs full-term infants.  

The study found that rates of RSV immunoprophylaxis were significantly lower in preterm infants born in 2014–2016 vs 2012–2014, reflecting the recommendations in the 2014 guidance. The decline in immunoprophylaxis was associated with an increased risk of RSV hospitalization among infants 29–34 weeks gestational age who were <6 months of age for both commercial- and Medicaid-insured. 

Specifically, there was a 2.5–5 times higher risk for preterm infants <6 months old to be hospitalized than full-term infants in 2014–2015; this increased to approximately a 3.5–5.5 times higher risk in 2015–2016. 

The study also analyzed US commercial and Medicaid insurance claims from >1.5 million infants aged <1 year. The study not only found an increased RSV hospitalization risk among preterm infants but also higher costs associated with the hospitalizations. For example, the average cost for an RSV hospitalization during the 2014–2016 RSV seasons for commercial infants <3 months was $17,416 for full-term infants vs. $39,174 for infants 29–34 weeks gestational age. Medicaid infants <3 months had an average cost of $9,824 for full-term infants vs. $22,316 for infants aged 29–34 weeks gestational age. 

Findings from this study support data from a prior study that showed a significant national increase in RSV hospitalizations among infants 29–34 weeks gestational age aged <3 months during the 2014–2015 RSV season vs the previous 4 seasons. 

Lead author, Dr Mitchell Goldstein, from Loma Linda University Children's Hospital, Loma Linda, CA, added, "These data build on previous studies and should prompt additional discussion of the importance of RSV prevention efforts among these high-risk infants. This is an important topic among advocates for preterm infant health and the health care community.”

Reference

AstraZeneca announces new data showing US preterm infants at signifcantlly greater risk of RSV hospitalizations  following 2014 guidance change [press release]. Gaithersburg, Maryland. AstraZeneca Pharmaceuticals LP. Published October 18, 2017. Accessed November 2, 2017.

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