• F Martín Ferolla, Diego R Hijano, Patricio L Acosta, Andrea Rodríguez, Karina Dueñas, Andrea Sancilio, Edgar Barboza, Adriana Caría, Guadalupe Fernández Gago, Rodrigo Egües Almeida, Laura Castro, Cecilia Pozzolo, María V Martínez, Luciano Alva Grimaldi, Beatriz Rebec, Mariel Calvo, Julieta Henrichsen, Celina Nocito, Mariela González, Guillermo Barbero, Juan Ves Losada, Mauricio T Caballero, Valeria Zurankovas, Mirta Raggio, Graciela Schavlovsky, Alicia Kobylarz, Vera Wimmenauer, Jimena Bugna, John V Williams, Gustavo Sastre, Edgardo Flamenco, Alberto Rodríguez Pérez, Fernando Ferrero, Romina Libster, Carlos G Grijalva, and Fernando P Polack.
• Fundación INFANT, Ciudad de Buenos Aires, Argentina.
• Am. J. Respir. Crit. Care Med.. 2013 May 1;187(9):983-90.

RationaleRespiratory syncytial virus (RSV) is an important cause of hospitalization and death in infants worldwide. Most RSV deaths occur in developing countries, where burden and risk factors for life-threatening illness are unclear.ObjectivesWe defined the burden of life-threatening (O(2) saturation [O(2) sat] ≤ 87%) and fatal RSV infection, and characterized risk factors for life-threatening disease in hospitalized children. Special emphasis was placed on studying the impact of dietary habits during pregnancy. We hypothesized that dietary preferences, differing from those of our remote ancestors, would negatively impact children's pulmonary health. For instance, a diet rich in carbohydrates is a signature of recent millennia and typical of low-income populations, heavily burdened by life-threatening RSV disease.MethodsProspective study in a catchment population of 56,560 children under 2 years of age during the RSV season in Argentina. All children with respiratory signs and O(2) sat less than 93% on admission were included.Measurements And Main ResultsAmong 1,293 children with respiratory infections, 797(61.6%) were infected with RSV: 106 of these had life-threatening disease; 1.9 per 1,000 children (95% confidence interval [CI], 1.5-2.2/1,000) under 24 months. A total of 22 hospitalized children died (9 RSV(+)), 26 died at home due to acute respiratory infection (14 attributed to RSV); all were under 12 months old. The annual attributable mortality rate for RSV was 0.7 per 1,000 infants (95% CI, 0.4-1.1/1,000). Life-threatening disease was dose-dependently associated with carbohydrate ingestion during pregnancy (adjusted odds ratio from 3.29 [95% CI, 1.15-9.44] to 7.36 [95% CI, 2.41-22.5] versus the lowest quartile).ConclusionsLife-threatening and fatal RSV infections are a heavy burden on infants in the developing world. Diets rich in carbohydrates during pregnancy are associated with these severe outcomes.

25 keywords...

hide…