Incidence of Respiratory Disease During the First Two Years of Life in Children with Hemodynamically Significant Congenital Heart Disease in Italy: A Retrospective Study

Giacomo Pongiglione, Alessandro Possidoni, Umberto di Luzio Paparatti, Anna Maria Costanzo, Giuliana Gualberti, Marco Bonvicini, Alessandro Rimini, Gabriella Agnoletti, Maria Pia Calabrò, Marco Pozzi, Roberto Tumbarello, Patrizia Salice, Patrizio Fiorini, Maria Giovanna Russo, Ornella Milanesi

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Abstract

Children affected by hemodynamically significant congenital heart disease (HSCHD) experience severe respiratory complications that can increase the frequency of hospitalizations. The aim of the SINERGY study was to describe the incidence of respiratory diseases and to collect information on active and passive immunoprophylaxis in the first 2 years of life. In this retrospective, multicenter, and epidemiologic study, children with HSCHD were enrolled across 11 Italian sites. Children born between December 31, 2007, and December 31, 2012, were observed during their first 2 years of life. Data were collected through hospital database searches and parent interviews. Four hundred twenty children were enrolled: 51.7 % were female, 79.5 % were born full-term (≥37 weeks), and 77.6 % weighed >2500 g at birth. The most frequent heart defects were ventricular septal defect (23.1 %) and coarctation of the aorta (14.3 %). The incidence of respiratory diseases was 63.1 %. Frequent respiratory diseases not requiring hospitalization were upper respiratory tract infections (76.4 %), acute bronchitis (43.3 %), and influenza (22.1 %), while those requiring hospitalization were bronchitis and bronchiolitis (8.3 % each one). While active immunoprophylaxis was applied with wide compliance (diphtheria/pertussis/tetanus, 99.5 %; Haemophilus influenzae type b, 72.5 %; pneumococcus, 79.9 %; meningococcus, 77.4 %), only 54 % of children received respiratory syncytial virus (RSV) passive prophylaxis (palivizumab). Of the 35 hospitalizations due to bronchiolitis, 27 (77.1 %) did not receive prophylaxis against RSV, compared with 8 (22.9 %) who received prophylaxis (P < 0.0001). Children with HSCHD are at major risk of respiratory diseases. Passive immunoprophylaxis can help to prevent hospitalizations for bronchiolitis.

Original languageEnglish
Pages (from-to)1581-1589
Number of pages9
JournalPediatric Cardiology
Volume37
Issue number8
DOIs
Publication statusPublished - Dec 2016

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Keywords

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Pongiglione, G., Possidoni, A., di Luzio Paparatti, U., Costanzo, A. M., Gualberti, G., Bonvicini, M., Rimini, A., Agnoletti, G., Calabrò, M. P., Pozzi, M., Tumbarello, R., Salice, P., Fiorini, P., Russo, M. G., & Milanesi, O. (2016). Incidence of Respiratory Disease During the First Two Years of Life in Children with Hemodynamically Significant Congenital Heart Disease in Italy: A Retrospective Study. Pediatric Cardiology, 37(8), 1581-1589. https://doi.org/10.1007/s00246-016-1473-9