CC BY-NC-ND 4.0 · Am J Perinatol 2018; 35(14): 1433-1442
DOI: 10.1055/s-0038-1660466
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Respiratory Syncytial Virus Hospitalizations among U.S. Preterm Infants Compared with Term Infants Before and After the 2014 American Academy of Pediatrics Guidance on Immunoprophylaxis: 2012–2016

Mitchell Goldstein
1  Division of Neonatal Medicine, Loma Linda University Children's Hospital, Loma Linda, California
Leonard R. Krilov
2  Pediatric Infectious Diseases, Children's Medical Center, NYU Winthrop, Mineola, New York
Jaime Fergie
3  Department of Pediatric Infectious Disease, Driscoll Children's Hospital, Corpus Christi, Texas
Kimmie K. McLaurin
4  AstraZeneca, Gaithersburg, Maryland
Sally W. Wade
5  Wade Outcomes Research and Consulting, Salt Lake City, Utah
David Diakun
6  Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
Gregory M. Lenhart
6  Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
Adam Bloomfield
4  AstraZeneca, Gaithersburg, Maryland
Amanda M. Kong
6  Truven Health Analytics, an IBM Company, Cambridge, Massachusetts
› Author Affiliations
Funding This analysis was funded by AstraZeneca.
Further Information

Publication History

07 March 2018

26 April 2018

Publication Date:
19 June 2018 (online)


Objective The objective of this study was to compare risk for respiratory syncytial virus (RSV) hospitalizations (RSVH) for preterm infants 29 to 34 weeks gestational age (wGA) versus term infants before and after 2014 guidance changes for immunoprophylaxis (IP), using data from the 2012 to 2016 RSV seasons.

Study Design Using commercial and Medicaid claims databases, infants born between July 1, 2011 and June 30, 2016 were categorized as preterm or term. RSVH during the RSV season (November–March) were identified for infants aged <6 months and rate ratios (RRs) for hospitalization comparing preterm and term infants were calculated. Difference-in-difference models were fit to evaluate the changes in hospitalization risks in preterm versus term infants from 2012 to 2014 seasons to 2014 to 2016 seasons.

Results In all seasons, preterm infants had higher RSVH rates than term infants. Seasonal RRs prior to the guidance change for preterm wGA categories versus term infants ranged from 1.6 to 3.4. After the guidance change, the seasonal RRs ranged from 2.6 to 5.6. In 2014 to 2016, the risk associated with prematurity of 29 to 34 wGA versus term was significantly higher than in 2012 to 2014 (P<0.0001 for commercial and Medicaid samples).

Conclusion In infants aged <6 months, the risk for RSVH for infants 29 to 34 wGA compared with term infants increased significantly after the RSV IP recommendations became more restrictive.


This work was presented as a poster titled “Respiratory syncytial virus hospitalization rates and costs among full-term and preterm infants before and after implementation of the 2014 American Academy of Pediatrics guidance on immunoprophylaxis” at AMCP Nexus 2017, Dallas, TX, October 16–19, 2017, and was presented as a poster titled “RSV Hospitalizations Before and Two Seasons After the 2014 American Academy of Pediatrics Guidance on RSV Immunoprophylaxis” at the 2018 Pediatric Academic Societies Annual Meeting, Toronto, Canada, May 5–8, 2018.

Supplementary Material