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Maternal Risk Factors for Respiratory Syncytial Virus Lower Respiratory Tract Infection in Otherwise Healthy Preterm and Term Infants: A Systematic Review and Meta-analysis

Paolo Manzoni, Elsa Viora, M. Lanari, Raffaella Iantomasi, Eva Agostina Montuori, B. Rodgers-Gray, Nicola Waghorne, Bianca Masturzo

The Pediatric Infectious Disease Journal, 2024

10 participants · 2 citations

Abstract

Background/objective: To date, there is no published, formal assessment of all maternal risk factors for respiratory syncytial virus lower respiratory tract infection (RSV-LRTI) in infants. A systematic literature review and meta-analysis were undertaken to ascertain: What maternal risk factors are associated with an increased risk of RSV-LRTI in infants? Methods: The systematic literature review used explicit methods to identify, select and analyze relevant data. PubMed, Embase and the Cochrane Library were searched (November 2022) using terms regarding: (1) RSV/LRTI; (2) risk factors; (3) pregnant/postpartum population. Bayesian meta-analysis compared RSV hospitalization (RSVH) risk in infants born to mothers with or without certain risk factors. Results: A total of 2353 citations were assessed and 20 were included in the final review (10 individual studies; 10 pooled analyses). In 10 studies examining infants (<1 year) without comorbidities (primary outcome), 10 maternal risk factors were associated with RSV-LRTI/RSVH in multivariate analyses. Meta-analysis revealed smoking while pregnant increased infant RSVH risk by 2.01 (95% credible interval: 1.52–2.64) times, while breast-feeding was protective (0.73, 95% credible interval: 0.58–0.90). Risk scoring tools have reported that maternal risk factors contribute between 9% and 21% of an infant’s total risk score for RSVH. Conclusions: A greater understanding of maternal risk factors and their relative contribution to infant…

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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10 participants or records.

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