Faculty Collaboration Database

Overweight Infants Hospitalized for Bronchiolitis Associated With Severe Disease. Hosp Pediatr 2023 Jan 01;13(1):e6-e10

Date

12/17/2022

Pubmed ID

36524326

DOI

10.1542/hpeds.2022-006746

Scopus ID

2-s2.0-85150030104 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVES: Overweight negatively affects pediatric respiratory function. In this study, we evaluate if overweight is associated with more severe bronchiolitis in hospitalized infants.

METHODS: This retrospective cohort study analyzed infants aged 30 to 365 days hospitalized for bronchiolitis from September 2019 to April 2020. Exclusion criteria included known risk factors for severe bronchiolitis, asthma treatment, or bacterial pneumonia. Weight-for-length z-score was categorized per the World Health Organization's growth assessments as overweight (z-score >2), underweight (z-score <-2), and standard weight (between -2 and ≤2). Primary outcomes included respiratory support, ICU stay, and local bronchiolitis score. Secondary outcomes included supplemental interventions.

RESULTS: After exclusion criteria, 385 of 644 infants were categorized as overweight (n = 24), standard (n = 335), or underweight (n = 26). There were differences in need for respiratory support (overweight, 100%; standard weight, 81.8%; underweight, 76.9%; P = .03), highest support of high-flow nasal cannula (overweight, 75%; standard weight, 48%; underweight, 42%; P = .03), admission to ICU (overweight, 54.2%; standard weight, 21.5%; underweight, 34.7%; P < .001), and median bronchiolitis score (overweight, 8 [interquartile range 5-10]; standard weight, 4 [3-7]; underweight, 4 [3-7]; P = .01). Findings remained significant after age adjustments. Additionally, overweight experienced higher frequency of certain treatments.

CONCLUSIONS: This study suggests overweight is associated with more severe bronchiolitis in hospitalized infants supported by increased respiratory support level, bronchiolitis scores, and interventions. Higher need for ICU admission may be related to high-flow nasal cannula limitations on the acute care floor.

Author List

Madion L, Bauer SC, Pan A, Parakininkas D, Karls C, McFadden V, Liljestrom T

Authors

Sarah Bauer MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Tracey H. Liljestrom MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Vanessa Mcfadden MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Amy Y. Pan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Daiva E. Parakininkas MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bronchiolitis
Cannula
Child
Humans
Infant
Overweight
Retrospective Studies
Thinness