Number of Children in the Household Influences Respiratory Morbidities in Children With Bronchopulmonary Dysplasia in the Outpatient Setting

Authors

Joseph M Collaco
Katharine R Tsukahara
Michael C Tracy
Catherine A Sheils
Jessica L Rice
Lawrence M Rhein
Antonia P Popova
Leif Nelin
Audrey N Miller
Winston M Manimtim
Jonathan C Levin
Khanh Lai
Jacob A Kaslow
Lystra P Hayden
Manvi Bansal
Eric D Austin
Brianna Aoyama
Gangaram Akangire
Amit Agarwal
Natalie Villafranco
Sharon A McGrath-Morrow

Publication Date

2-1-2024

Journal

Pediatric Pulmonology

DOI

10.1002/ppul.26747

PMID

37937888

PMCID

PMC10872663

PubMedCentral® Posted Date

2-1-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Infant, Newborn, Child, Humans, Infant, Bronchopulmonary Dysplasia, Outpatients, Surveys and Questionnaires, Infant, Premature, Hospitalization, bronchopulmonary dysplasia, outpatient, symptoms, siblings, acute care use

Abstract

BACKGROUND: Bronchopulmonary dysplasia (BPD), a common complication of prematurity, is associated with outpatient morbidities, including respiratory exacerbations. Daycare attendance is associated with increased rates of acute and chronic morbidities in children with BPD. We sought to determine if additional children in the household conferred similar risks for children with BPD.

METHODS: The number of children in the household and clinical outcomes were obtained via validated instruments for 933 subjects recruited from 13 BPD specialty clinics in the United States. Clustered logistic regression models were used to test for associations.

RESULTS: The mean gestational age of the study population was 26.5 ± 2.2 weeks and most subjects (69.1%) had severe BPD. The mean number of children in households (including the subject) was 2.1 ± 1.3 children. Each additional child in the household was associated with a 13% increased risk for hospital admission, 13% increased risk for antibiotic use for respiratory illnesses, 10% increased risk for coughing/wheezing/shortness of breath, 14% increased risk for nighttime symptoms, and 18% increased risk for rescue medication use. Additional analyses found that the increased risks were most prominent when there were three or more other children in the household.

CONCLUSIONS: We observed that additional children in the household were a risk factor for adverse respiratory outcomes. We speculate that secondary person-to-person transmission of respiratory viral infections drives this finding. While this risk factor is not easily modified, measures do exist to mitigate this disease burden. Further studies are needed to define best practices for mitigating this risk associated with household viral transmission.