Risk Factors for Severe Bronchiolitis in Australian and Aotearoa New Zealand Infants: A Systematic Review

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2025-08-08 DOI:10.1111/jpc.70165

Kate Loveys, Meredith L. Borland, Ed Oakley, Franz E. Babl, Elizabeth Cotterell, Libby Haskell, Sharon O’Brien, Catherine L. Wilson, Emma J. Tavender, Stuart R. Dalziel, the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network

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引用次数: 0

Abstract

Aim

Bronchiolitis is the leading cause of hospital admission in Australasian infants. Infants with risk factors for severe disease may have a greater likelihood of prolonged hospitalisation and intensive care admission. This study aimed to synthesise the literature on risk factors for severe bronchiolitis in Australasian infants.

Methods

Systematic review including observational studies of risk factors for severe bronchiolitis in Australasian infants (< 12 months), published from 2000. Databases were searched (24 January 2024): MEDLINE, EMBASE, PubMed, Cochrane Library and CINAHL. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale for cohort studies, and evidence quality was evaluated using GRADE. Results were narratively synthesised.

Results

Ten out of 26 467 articles were included (N = 895 276; 12 cohorts, prospective = 5, retrospective = 7). Studies were mostly rated low RoB. There was evidence for the following risk factors: younger chronological age, prematurity, plural birth, comorbidity (chronic lung disease, congenital heart disease, chronic neurological disease, any genetic disorder, any comorbidity), Indigenous ethnicity, economic disadvantage, tobacco smoke exposure and timing of illness onset at presentation. Most risk factors had moderate-quality evidence (range high to very low). Evidence was lacking for the following risk factors present in international literature: breastfeeding exposure and faltering growth. The following risk factors have not been reported in Australasian infants: trisomy-21, congenital diaphragmatic hernia and environmental pollutants.

Conclusions

Risk factors for severe bronchiolitis in Australasian infants are largely consistent with the international literature, although evidence is lacking for some. Knowledge of these risk factors is highly relevant to those assessing infants with bronchiolitis, and in guiding targeted delivery of respiratory syncytial virus immunisation and other preventative programmes.

Trial Registration

PROSPERO (CRD42023463917)

Abstract Image

查看原文本刊更多论文

澳大利亚和新西兰婴幼儿严重毛细支气管炎的危险因素：系统综述。

目的：毛细支气管炎是澳大利亚婴儿住院的主要原因。具有严重疾病危险因素的婴儿可能更有可能长期住院和接受重症监护。本研究旨在综合有关澳大利亚婴儿严重毛细支气管炎危险因素的文献。方法：系统回顾包括澳大利亚婴儿严重毛细支气管炎危险因素的观察性研究(结果：26467篇文章中有10篇被纳入(N = 895276；12个队列，前瞻性= 5，回顾性= 7)。研究大多被评为低RoB。有证据表明下列风险因素：实际年龄较低、早产、多胞胎、共病（慢性肺病、先天性心脏病、慢性神经疾病、任何遗传疾病、任何共病）、土著民族、经济劣势、接触烟草烟雾和发病时间。大多数危险因素有中等质量的证据（范围从高到极低）。国际文献中缺乏以下风险因素的证据：母乳喂养和生长迟缓。以下危险因素在澳大拉西亚婴儿中尚未报道：21三体、先天性膈疝和环境污染物。结论：澳大利亚婴儿严重毛细支气管炎的危险因素与国际文献基本一致，尽管缺乏证据。了解这些危险因素与评估毛细支气管炎婴儿、指导有针对性地进行呼吸道合胞病毒免疫接种和其他预防规划高度相关。试验注册：PROSPERO （CRD42023463917）。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.