Born vulnerable: Why RSV is a greater threat to newborns, premature babies

Premature babies face a greater threat from RSV infection due to their underdeveloped lungs, airways, and immune systems. Kuching, Malaysia has seen such cases, with one premature baby requiring hospitalization several times after contracting RSV. Dr Amita Vivehanantham, a neonatologist, recounted the case of a baby who, after experiencing poor feeding and nasal congestion, was admitted and required oxygen therapy and feeding via a tube for about five days.

Dr Wong Ann Cheng, another Kuching-based neonatologist, explained that critical stages of lung and immune development take place during the third trimester of pregnancy. When a baby is born prematurely, these processes are disrupted, leaving the infant with smaller airways, underdeveloped lungs, weaker immune defenses, and fewer maternal antibodies to combat infection. Even minor RSV-induced airway swelling and mucus can severely constrict a premature baby's airways, making respiration more strenuous.

Although the baby may be discharged from the NICU, which marks a significant milestone, it doesn't imply complete lung and immune system maturity. Dr Wong emphasized that premature infants and those with chronic lung disease, congenital heart disease, or other medical conditions remain at high risk. RSV can cause inflammation, leading to further airway obstruction and mucus production, which may overwhelm the already compromised lungs of a premature infant.