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Frequency of respiratory deterioration after immunisation in preterm infants
Author(s) -
Hacking Douglas F,
Davis Peter G,
Wong Ester,
Wheeler Kevin,
McVer Jodie
Publication year - 2010
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2010.01832.x
Subject(s) - medicine , pediatrics , continuous positive airway pressure , incidence (geometry) , odds ratio , confidence interval , cohort study , cohort , respiratory system , mechanical ventilation , low birth weight , pregnancy , anesthesia , physics , obstructive sleep apnea , optics , biology , genetics
Aim: To determine the relationship between the initiation of respiratory support and the first routine immunisation of neonates at 2 months of age during primary hospitalisation. Methods: An historical cohort study design was used to study the neonatal factors associated with the initiation of respiratory support within 7 days of immunisation in a cohort of 7629 preterm and term infants admitted to the Neonatal Unit of the Royal Women's Hospital between 2001 and 2008. Results: The 411 infants who received their first immunisations in hospital were both very preterm and of extremely low birth weight (ELBW, below 1000 g). Twenty‐two infants experienced post‐immunisation apnoea of sufficient severity to warrant the initiation of either intermittent positive pressure ventilation (two cases) or continuous positive airway pressure (20 cases). Infants exhibiting a respiratory deterioration following immunisation had a higher incidence of previous septicaemia (Odds ratio 2.5, 95% confidence interval 1.0, 6.1; P = 0.04) and received CPAP for a longer period prior to vaccination ( P = 0.03). Conclusion: Apnoea following immunisation may be an aetiological factor in the requirement of respiratory support in a small number of preterm, ELBW infants particularly those with significant lung disease and those who have previously experienced septicaemia.