Figueras-Aloy J, Quero-Jiménez J, Fernández-Colomer B, Guzmán-Cabañas J, Echaniz-Urcelay I, Doménech-Martínez E
Servicio de Neonatología, Hospital Clínic, Barcelona, España.
An Pediatr (Barc). 2009 Jul;71(1):47-53. doi: 10.1016/j.anpedi.2009.04.010. Epub 2009 Jun 12.
The aim of the study was to evaluate the risk factor associations for respiratory syncytial virus (RSV) hospitalization in preterm infants from 32 to 35 weeks gestation, treated during two consecutive RSV seasons in Spain.
A database (FLIP-2) was used after excluding the infants who received prophylactic palivizumab. A total of 193 RSV+ admissions and 4568 non-hospitalized children were studied. The risk factors analyzed were: chronological age <=10 weeks at start of RSV season or to be born during the first 10 weeks of the season; school-age siblings or daycare attendance; mother smoking during pregnancy; male gender; breastfeeding <=2 months; >=4 adults at home; history of wheezing; small for gestational age; >=2 smokers at home.
Logistic regression model included the first four previously mentioned risk factors as independently significant variables, with R(2) of 0.062 and area under curve of 0.687 (P<0.001). Predictive values for a child with the four risk factors were: sensitivity 6.2%, specificity 98.6%, predictive positive value 16.2%, negative predictive value 96.1%, accuracy 94.9%, positive likelihood ratio 4.581, and negative likelihood ratio 0.951. Positive likelihood ratio for a child with the two major risk factors is 2.657.
Usefulness of different risk factor associations to predict hospitalization for respiratory syncytial virus infection in preterm infants 32 to 35 weeks gestation in Spain is low, although similar to other models.
本研究旨在评估西班牙连续两个呼吸道合胞病毒(RSV)流行季节中,孕32至35周早产儿因RSV住院的风险因素关联。
在排除接受预防性帕利珠单抗治疗的婴儿后,使用了一个数据库(FLIP - 2)。共研究了193例RSV阳性入院患儿和4568例未住院儿童。分析的风险因素包括:RSV流行季节开始时实足年龄≤10周或在该季节的前10周内出生;有学龄期兄弟姐妹或参加日托;母亲孕期吸烟;男性;母乳喂养≤2个月;家中≥4名成年人;喘息病史;小于胎龄儿;家中≥2名吸烟者。
逻辑回归模型将上述前四个风险因素列为独立的显著变量,R²为0.062,曲线下面积为0.687(P<0.001)。具有这四个风险因素的儿童的预测值为:敏感性6.2%,特异性98.6%,阳性预测值16.2%,阴性预测值96.1%,准确性94.9%,阳性似然比4.581,阴性似然比0.951。具有两个主要风险因素的儿童的阳性似然比为2.657。
在西班牙,不同风险因素关联对预测孕32至35周早产儿呼吸道合胞病毒感染住院的有用性较低,尽管与其他模型相似。