Risk factors for bronchiolitis hospitalization in infants: A French nationwide retrospective cohort study over four consecutive seasons (2009-2013)

Brigitte Fauroux (1, 2) , J.M. Hascoët (3, 4) , Pierre-Henri Jarreau (5, 6) , Jean-François Magny (7) , Jean-Christophe Rozé (8, 9) , Elie Saliba (10) , Michaël Schwarzinger (11, 12, 13)

1 VIFASOM (URP_7330) - Sommeil-Vigilance-Fatigue et Santé Publique
2 Unité Pédiatrique de Ventilation Non Invasive et de Sommeil [CHU Necker Enfants-Malades]
3 Maternité Régionale Adolphe Pinard [Nancy]
4 DevAH - Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité
5 UPCité - Université Paris Cité
6 Hôpital Cochin [AP-HP]
7 Hôpital Necker - Enfants Malades [AP-HP]
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes
9 PhAN - Physiopathologie des Adaptations Nutritionnelles
10 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
11 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
12 THEN - Translational Health Economics Network [Paris]
13 SU - Sorbonne Université

Objectives: Large studies are needed to update risk factors of bronchiolitis hospitalization. We performed a nationwide analysis of hospitalization rates for bronchiolitis over four consecutive bronchiolitis seasons to identify underlying medical disorders at risk of bronchiolitis hospitalization and assess their frequency. Methods: Data were retrieved from the French National Hospital Discharge database. Of all infants discharged alive from maternity wards from January 2008 to December 2013 in France (N = 3,884,791), we identified four consecutive cohorts at risk of bronchiolitis during the seasons of 2009–2010 to 2012–2013. The main outcome was bronchiolitis hospitalization during a season. Individual risk factors were collected. Results: Among infants, 6.0% were preterm and 2.0% had ≥1 chronic condition including 0.2% bronchopulmonary dysplasia (BPD) and 0.2% hemodynamically significant congenital heart disease (HS-CHD). Bronchiolitis hospitalization rates varied between seasons (min: 1.26% in 2010–2011; max: 1.48% in 2012–2013; p<0.001). Except omphalocele, the following conditions were associated with an increased risk for bronchiolitis hospitalization: solid organ (9.052; 95% CI, 4.664–17.567) and stem cell transplants (6.012; 95% CI, 3.441–10.503), muscular dystrophy (4.002; 95% CI, 3.1095–5.152), cardiomyopathy (3.407; 95% CI, 2.613–4.442), HS-CHD (3.404; 95% CI, 3.153–3.675), congenital lung disease and/or bronchial abnormalities, Down syndrome, congenital tracheoesophageal fistula, diaphragmatic hernia, pulmonary hypertension, chromosomal abnormalities other than Down syndrome, hemodynamically non-significant CHD, congenital abnormalities of nervous system, cystic fibrosis, cleft palate, cardiovascular disease occurring during perinatal period, and BPD. Conclusion: Besides prematurity, BPD, and HS–CHD, eighteen underlying conditions were associated with a significant increased risk for bronchiolitis hospitalization in a nationwide population.

Domaines: Pédiatrie; Maladies infectieuses; Pneumologie et système respiratoire; Santé publique et épidémiologie

Brigitte Fauroux, J.M. Hascoët, Pierre-Henri Jarreau, Jean-François Magny, Jean-Christophe Rozé, et al.. Risk factors for bronchiolitis hospitalization in infants: A French nationwide retrospective cohort study over four consecutive seasons (2009-2013). PLoS ONE, 2020, 15 (3), pp.e0229766. ⟨10.1371/journal.pone.0229766⟩. ⟨hal-02943609⟩