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Environmental exposures and respiratory morbidity among very low birth weight infants at 1 year of life
  1. J S Halterman1,
  2. K A Lynch1,
  3. K M Conn1,
  4. T E Hernandez1,
  5. T T Perry2,
  6. T P Stevens1
  1. 1
    Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
  2. 2
    Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  1. 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}


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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  • Competing interests: None.

  • Ethics approval: This study was approved by the University’s Institution Review Board.

  • Patient consent: Obtained.

  • Contributors: JH, KL, KC and TS designed the research study. KL and TH collected the data. JH, KL and TH prepared the manuscript. TP and TS provided expert consultation regarding the analytic plan and presentation of the manuscript. All authors contributed to the manuscript’s submitted form and have read and approved the final manuscript.