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. 2022 Dec;57(12):2903-2914.
doi: 10.1002/ppul.26128. Epub 2022 Sep 19.

Respiratory infections in children born preterm in low and middle-income countries: A systematic review

Shivashankar Diggikar  1 , Abhishek Paul  2 , Abdul Razak  3   4 , Manigandan Chandrasekaran  5 , Ravi Shankar Swamy  2   6
Affiliations

Respiratory infections in children born preterm in low and middle-income countries: A systematic review

Shivashankar Diggikar et al. Pediatr Pulmonol. 2022 Dec.

Abstract

Context: Studies from high-income countries indicates that infants born preterm are at increased risk of respiratory infections; however in the low and middle-income countries (LMICs) data are limited. Our aim was to systematically review the studies evaluating the risk of respiratory infections in preterm children born in LMICs.

Methods: We searched Medline, PubMed, Cumulative Index of Nursing and Allied Health Literature, Embase, and Psych-INFO databases for studies reporting respiratory outcomes in children born preterm in LMICs. Two authors extracted the data and evaluated the risk of bias with appropriate assessment methods independently.

Results: Twelve observational studies evaluating 5969 children were included in the review. The risk of lower respiratory tract infection varied from 5% to 73.9%. Similarly, respiratory syncytial virus (RSV) infection risk ranged from 4.4% to 22.7%. The unadjusted relative risk for any respiratory tract infection or lower respiratory tract infection was significantly higher in the children born preterm than in children born at term (1.52 [95% confidence interval 1.25-1.85]). We also noted wide-ranging risk of respiratory infections requiring in-hospital or emergency care (range: 0.5%-27.7%) and hospital stay in children born preterm (range: 6-14.3 days).

Conclusions: Preterm-born children in LMICs are at risk of increased respiratory infections compared to term-born children; however, the baseline risk is variable, although substantial; This highlights the need for preventive strategies, including RSV immunoprophylaxis.

Keywords: LRTI; bronchiolitis; low birth weight; pneumonia; premature; respiratory syncytial virus; ventilation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of search results (adapted from PRISMA 2021). PRISMA, Preferred Reporting Items for Systematic Reviews and Meta‐analyses.
See this image and copyright information in PMC

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