Objectives: To determine the rates of hospital admission for respiratory syncy tial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis ...Objectives: To determine the rates of hospital admission for respiratory syncy tial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis on admissions for RSV infection. Design: Retrospective cohort study of children born in 1991-2000.Se tting: Tertiary care university hospital. Methods: Data on all children born dur ing the 10 year period were combined with information on laboratory confirmed RS V infections in these children until the end of 2002.The theoretical impact of palivizumab on RSV associated admissions was estimated by applying the current r ecommendations for prophylaxis to the study population and using the observed ra tes of admission in the calculations. Interventions: None. Main outcome measures : Rates of RSV infection and hospital admission in different subgroups of childr en. Results: Children with chronic lung disease (CLD) were admitted for RSV infe ction at a rate of 12.0%. The corresponding rates in children born at ≤28 or 29-32 weeks gest ation were 7.1 %and 6.8%respectively. Children born at ≤32 weeks gestation accounted for 6.6%of all admissions due to RSV. Of 580 children who would have met the criteria for palivizumab prophylaxis, 27 (4.6%) were admitted with RS V during the presumed prophylactic period. The number needed to treat to prevent one admission for RSV infectionwas 15 for childrenwith CLD (with a total cost o f e75 000) and 43 for children without CLD born at ≤32 weeks gestation (with a total cost of e215 000). Conclusions: The rates of hospital admission for RSV in fection in premature infants were substantially lower than those in most previou s reports from other countries. Determination of the local rates of RSV admissio ns in different groups of children would be useful in making decisions about the use of palivizumab.展开更多
Objective: To investigate the effect of parental visits during neonatal intensive care on the behavioral and emotional development of the child at school age. Design: All premature infants born in Tampere University H...Objective: To investigate the effect of parental visits during neonatal intensive care on the behavioral and emotional development of the child at school age. Design: All premature infants born in Tampere University Hospital in Tampere, Finland, in 1989 who were admitted to the neonatal intensive care unit and who lived in the Tampere region (N = 67; 31 boys and 36 girls) formed the study group. Data on parental visits were collected from the hospital records. Child behavior was evaluated according to the Achenbach Child Behavior Checklist at the age of 7 to 8 years. A total of 48 (72%) of the mothers returned the questionnaires. Results: The median number of visiting days per week was 6.2 for the mothers and 4.7 for the fathers. The children whose mothers visited daily had fewer behavioral and emotional problems at school age than those who had had fewer visits from their mothers (P=.04). The visiting frequency of the fathers was not significantly associated with later behavioral and emotional problems of the child. In this study, infrequent visits by the mother were a stronger risk factor for later psychological development than the medical risks of the preterm infant. Conclusions: Infrequent visits by mothers to the neonatal intensive care unit seem to be a marker for their children’s later behavioral and emotional problems. This emphasizes the significance of early parent-infant contact and the vulnerability in early interaction. Less frequent visits may also indicate factors influencing the parent-child relationship in a way that leads to subsequent behavioral problems.展开更多
文摘Objectives: To determine the rates of hospital admission for respiratory syncy tial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis on admissions for RSV infection. Design: Retrospective cohort study of children born in 1991-2000.Se tting: Tertiary care university hospital. Methods: Data on all children born dur ing the 10 year period were combined with information on laboratory confirmed RS V infections in these children until the end of 2002.The theoretical impact of palivizumab on RSV associated admissions was estimated by applying the current r ecommendations for prophylaxis to the study population and using the observed ra tes of admission in the calculations. Interventions: None. Main outcome measures : Rates of RSV infection and hospital admission in different subgroups of childr en. Results: Children with chronic lung disease (CLD) were admitted for RSV infe ction at a rate of 12.0%. The corresponding rates in children born at ≤28 or 29-32 weeks gest ation were 7.1 %and 6.8%respectively. Children born at ≤32 weeks gestation accounted for 6.6%of all admissions due to RSV. Of 580 children who would have met the criteria for palivizumab prophylaxis, 27 (4.6%) were admitted with RS V during the presumed prophylactic period. The number needed to treat to prevent one admission for RSV infectionwas 15 for childrenwith CLD (with a total cost o f e75 000) and 43 for children without CLD born at ≤32 weeks gestation (with a total cost of e215 000). Conclusions: The rates of hospital admission for RSV in fection in premature infants were substantially lower than those in most previou s reports from other countries. Determination of the local rates of RSV admissio ns in different groups of children would be useful in making decisions about the use of palivizumab.
文摘Objective: To investigate the effect of parental visits during neonatal intensive care on the behavioral and emotional development of the child at school age. Design: All premature infants born in Tampere University Hospital in Tampere, Finland, in 1989 who were admitted to the neonatal intensive care unit and who lived in the Tampere region (N = 67; 31 boys and 36 girls) formed the study group. Data on parental visits were collected from the hospital records. Child behavior was evaluated according to the Achenbach Child Behavior Checklist at the age of 7 to 8 years. A total of 48 (72%) of the mothers returned the questionnaires. Results: The median number of visiting days per week was 6.2 for the mothers and 4.7 for the fathers. The children whose mothers visited daily had fewer behavioral and emotional problems at school age than those who had had fewer visits from their mothers (P=.04). The visiting frequency of the fathers was not significantly associated with later behavioral and emotional problems of the child. In this study, infrequent visits by the mother were a stronger risk factor for later psychological development than the medical risks of the preterm infant. Conclusions: Infrequent visits by mothers to the neonatal intensive care unit seem to be a marker for their children’s later behavioral and emotional problems. This emphasizes the significance of early parent-infant contact and the vulnerability in early interaction. Less frequent visits may also indicate factors influencing the parent-child relationship in a way that leads to subsequent behavioral problems.
