Factors Associated with Receipt of Palivizumab among Inner-city Infants
Authors: David Wood, Katryne Lukens-Bull, Kristi Stowers, Mark Hudak and William Livingood
Abstract: Objective: To determine rate of receipt of palivizumab and factors associated with receipt among poor, inner-city, ex-premature infants. Study Design: Infants from an urban neonatal intensive care unit (NICU) who qualify for palivizumab (by AAP criteria) were prospectively followed through the infant’s first RSV season. Parent interviews were conducted at the end of the season to identify factors associated with receipt of palivizumab. Structured provider record reviews assessed receipt of palivizumab. Results: High receipt of palivizumab (34-100% of recommended number of doses) was associated with the following factors: 1) infant was < 3 months of age at the start of the RSV season (OR = 4.32; 95% CI = 1.65, 11.34); 2) a formal development assessment was conducted by the primary care pediatrician by 6 months of age (OR = 3.71; 95% CI = 1.4, 9.83); and 3) the mother reported no emergency room visit by the infant during the RSV season (OR = 3.02; 95% CI = 1.09, 8.42). Conclusions: Receipt of palivizumab for inner-city infants was very low. Prospective identification of infants at risk of not receiving palivizumab may be possible. More organized follow-up of inner-city, high-risk newborns is needed.