Table 2.
Summary of Evidence That Examined RSV Hospitalization in Infants 29–35 wGA After the 2014 AAP Policy Change.
| Study (RSV seasons) | Study design | Major conclusions |
|---|---|---|
| Evidence showing increase in RSV morbidity after 2014 | ||
| Krilov et al. (2020) (2011–2014 vs. 2014–2017) | Retrospective observational study using Optum Research Database in infants 29–34 wGA | – RSV IP use decreased significantly – RSVH risk in infants 29–34 wGA vs. term infants increased by 55% – RSVH severity and cost also increased |
| Anderson et al. (2020); SENTINEL1 (2014–2016) | Large, multicenter, observational study in infants 29–35 wGA who did not receive RSV IP | – RSVH was often severe (required ICU admission and mechanical ventilation) and was associated with high hospital charges |
| Goldstein et al. (2018) (2012–2014 vs. 2014–2016) | Retrospective analysis using Truven MarketScan® Database in infants 29–34 wGA | – RSV IP use decreased significantly – RSVH risk in infants 29–34 wGA vs. term infants increased by up to two fold – Hospital costs also increased |
| Kong et al. (2018) (2013–2014 vs. 2014–2015) | Retrospective analysis using Truven MarketScan® Database in infants 29–34 wGA | – RSV IP use decreased significantly – RSVH risk in infants 29–34 wGA vs. term infants increased by up to 2.7-fold |
| Rajah et al. (2017) (2013–2014 vs. 2014–2015) | Retrospective study conducted at Nationwide Children’s Hospital in infants 29–34 wGA | – Proportion of RSVH increased significantly – Severity and hospital charges also increased |
| Blake et al. (2017) (2012–2014 vs. 2014–2016) | Retrospective study conducted at Duke University Health System in infants born between 29 and less than 32wGA aged younger than 12 months | – RSV IP use decreased significantly – RSVH increased significantly |
| Evidence showing no increase in RSV morbidity after 2014 | ||
| Zembles et al. (2019) (2012–2014 vs. 2014–2017) | Retrospective regional study in infants 29–34 wGA | – RSVH rates and morbidity did not increase significantly |
| Farber (2017) (2012–2014 vs. 2014–2015) | Retrospective study using Texas Medicaid claims in infants 29–32 wGA | – RSVH rates did not increase significantly |
Note. AAP = American Academy of Pediatrics; ICU = intensive care unit; IP = immunoprophylaxis; RSV = respiratory syncytial virus; RSVH = respiratory syncytial virus hospitalization; wGA = weeks’ gestational age.