Environmental Exposures and Respiratory Morbidity among Very Low Birth Weight Infants at One Year of Life

Jill Suzanne Halterman ^1*, Kathleen Lynch ¹, Kelly Conn ¹, Telva Hernandez ¹, Tamara T. Perry ² and Timothy Stevens ¹

¹ University of Rochester
² University of Arkansas for Medical Sciences

^* To whom correspondence should be addressed. E-mail: jill_halterman{at}urmc.rochester.edu.

Accepted 28 July 2008

Abstract

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 birthweight (VLBW) infants.

Objectives: 1) Assess the rates of respiratory morbidity and exposure to indoor respiratory triggers in a population of VLBW infants at one 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 one 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 one year, 9% of infants had physician-diagnosed asthma, 47% required >1 acute visit and 11% required hospitalization 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, BPD, and family history of asthma or allergies, both living with a smoker (OR 2.62; CI 1.09, 6.29) and exposure to pests (OR 4.41; CI 1.22, 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.