Development and validation of a perinatal risk prediction model for recurrent respiratory tract infections in moderate-to-late preterm infants: a retrospective cohort study
Abstract
Despite significant advancements in neonatal care, mid to late preterm infants (32–36 weeks’ gestation) remain at high risk for recurrent respiratory tract infections (RRTIs). Current prevention strategies are limited by the absence of individualized risk assessment tools. This study aimed to identify critical perinatal risk factors and to develop a robust, clinically applicable prediction model for RRTI in this vulnerable population. A retrospective cohort study was conducted at a tertiary care hospital, enrolling 288 preterm infants born between April 2023 and April 2024. Comprehensive maternal, perinatal, and postnatal data were extracted from electronic medical records and supplemented by structured caregiver interviews. A multivariable logistic regression analysis using a stepwise selection method (entry criterion: P 0.10) was performed to determine independent predictors of RRTI. The derived model was externally validated in a temporally distinct cohort (n = 100) from the same center. Model performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Seven independent predictors were retained in the final model: small-for-gestational-age (OR = 3.53, 95% CI: 1.41–11.61), intrauterine infection (OR = 4.22, 95% CI: 1.81–9.83), mechanical ventilation > 72 h (OR = 3.00, 95% CI: 1.27–7.14), prolonged antibiotic use (> 30 days/year; OR = 2.23, 95% CI: 1.01–5.05), maternal passive smoking (OR = 2.91, 95% CI:…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 288 participants or records.
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