Archives of Disease in Childhood 2009;94:28-32
ORIGINAL ARTICLES
Environmental exposures and respiratory morbidity among very low birth weight infants at 1 year of life
1 Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
2 Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
Correspondence to:
Jill S Halterman, University of Rochester School of Medicine and Dentistry, Box 777, Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, New York 14642, USA; jill_halterman{at}urmc.rochester.edu
Introduction: Preterm infants have a substantially increased risk of developing respiratory illnesses. The goal of this study was to consider the impact of modifiable postnatal exposures on respiratory morbidity among a cohort of very low birth weight (VLBW) infants.
Objectives: (1) Assess the rates of respiratory morbidity and exposure to indoor respiratory triggers in a population of VLBW infants at 1 year; (2) determine the association between exposures and respiratory morbidity.
Methods: We enrolled 124 VLBW infants into a prospective cohort study. Parents were called at 1 year to assess respiratory outcomes and environmental exposures. We used bivariate and multivariate analyses to assess the relationship between environmental exposures and acute care for respiratory illnesses.
Results: At 1 year, 9% of infants had physician-diagnosed asthma, 47% required 
1 acute visit and 11% required hospitalisation for respiratory illness. The majority of infants (82%) were exposed to at least one indoor respiratory trigger. Infants living with a smoker (61% vs 40%) and infants exposed to pests (62% vs 39%) were more likely than unexposed infants to require acute care for respiratory problems. In a multivariate regression controlling for demographics, birth weight, bronchopulmonary dysplasia, and family history of asthma or allergies, both living with a smoker (OR 2.62; CI 1.09 to 6.29) and exposure to pests (OR 4.41; CI 1.22 to 15.94) were independently associated with the need for acute care for respiratory illnesses.
Conclusions: In this sample, respiratory morbidity and exposure to triggers were common. VLBW infants may benefit from interventions that decrease exposure to respiratory triggers.
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