Population-based study of the impact of childcare attendance on hospitalizations for acute respiratory infections

OBJECTIVES. It is well known that children attending childcare have a higher risk of acute respiratory infections compared with children in home care; however, knowledge is sparse regarding how the excess risk of acute respiratory infection varies with age, time since enrollment, and other factors. METHODS. A national register-based study of 138 821 inpatient admissions to hospital for acute respiratory infection during 3 982 925 person-years of follow-up in Danish children aged 0 to 5 years. Data on child and family characteristics, childcare attendance, and hospitalizations were obtained from Danish registries. The outcome of the study was inpatient admissions to hospital for acute respiratory infection. Incidence rate ratios were estimated using Poisson regression. RESULTS. In children CONCLUSIONS. The increased risk of acute respiratory infection was most pronounced among 0- to 2-year-old children living with no other children during the first 6 months of enrollment. Our findings may suggest that it would be optimal to postpone enrollment into childcare until after 1 year of age. Key Words childcare, acute respiratory infection, morbidity, epidemiology Abbreviations ARI--acute respiratory infection DCRS--Danish Civil Registration System DNPR--Danish National Patient Registry ICD--International Classification of Diseases URI--upper respiratory infection LRI--lower respiratory infection IRR--incidence rate ratio CI--confidence interval
PREVIOUS STUDIES HAVE consistently found that children who are taken care of in a childcare facility away from their home have a higher risk of acute respiratory infections (ARIs) than [...]