FROM PEDIATRICS
Despite concerns that preterm infants with bronchopulmonary dysplasia (BPD) are more likely to experience respiratory decompensation after immunization than those without BPD, no difference in the incidence of respiratory decompensation within 72 hours after immunization was found between these groups in a cohort study at a tertiary care facility, according to a report published April 11 in Pediatrics.
These results demonstrate the safety of immunizing preterm infants with BPD, and that the findings should negate delays in immunizations in these patients based on safety concerns described in previous studies, Dr. Edwin Clark Montague of Emory University, Atlanta, and his colleagues assert.
In a retrospective observational study, Dr. Clark and his associates assessed a cohort of infants admitted to the NICU at a level 4, nonbirthing referral hospital, Children’s Healthcare of Atlanta at Egleston, who received any immunizations while hospitalized between Jan. 1, 2008, and Aug. 1, 2014. Inclusion criteria were birth at less than 32 weeks’ estimated gestational age and the availability of data for 72 hours before and 72 hours after immunization. The incidence of respiratory decompensation and cardiorespiratory events (apnea, bradycardia, desaturations) after immunization was compared between infants with and without BPD after immunization (Pediatrics. 2016 doi: 10.1542/peds.2015-4225).
Of the 403 patients assessed, 240 met the inclusion criteria. Of these, 170 were identified as having BPD and were compared with the 70 patients without BPD. The study results revealed no statistically significant difference in respiratory decompensation between patients with and without BPD. In addition, both groups showed an increased incidence of cardiorespiratory events, but there was no statistically significant difference between those with and without BPD.
In addition to BPD, the authors assessed risk factors that may predispose preterm infants to respiratory decompensation after immunization, such as a history of necrotizing enterocolitis or spontaneous intestinal perforation, grade III or IV intraventricular hemorrhage, or periventricular leukomalacia. Results from these analyses indicated that severe intraventricular hemorrhage was a predictor of respiratory decompensation after immunization, and that a positive blood culture within 72 hours of immunization was predictive as well. The authors said that decompensation was likely secondary to the underlying infection in those with positive blood cultures, but that additional research would be required to better understand this finding.
The authors reported no external funding sources and no financial relationships relevant to this article.
