CHRONIC LUNG-DISEASE FOLLOWING NEONATAL VENTILATION .1. INCIDENCE IN 2 GEOGRAPHICALLY DEFINED POPULATIONS

The objective of this study was to compare the incidence of chronic lu ng disease following neonatal ventilation in two geographically define d populations. Prospective data collection was carried out over a 1 ye ar period from March 11, 1990 to February 28, 1991 in the Trent Health Region (England) and in British Columbia, Canada. All infants less th an or equal to 32 weeks gestation and/or less than or equal to 1500 g birthweight born to mothers normally resident in either the Trent Heal th Region or British Columbia were included. The main outcome measures were mortality rate, presence of chronic lung disease, days of ventil ation, and oxygen used by each infant. The proportion of shortened ges tation, low birthweight babies was 1.5% in Trent and 1.2% in British C olumbia (957 of 63,350 births in Trent and 526 of 45,333 births in Bri tish Columbia). There were no significant differences in mean birthwei ght or gestation between the two cohorts, but there was a trend toward s lower mortality for infants 750-1500 g birthweight in British Columb ia. The incidence of chronic lung disease (using either of two definit ions) was significantly higher in British Columbia, with a correspondi ng greater amount of respiratory care required. This occurred despite higher use of antenatal steroids and surfactant therapy in the British Columbia group. We conclude that there are important clinical and res ource implications resulting from the number of ventilator and oxygen days used by the preterm population in terms of planning of neonatal s ervices. The role of individual treatment modalities in producing diff erences in the incidence of chronic lung disease warrants further stud y in the setting of a geographically defined population. (C) 1996 Wile y-Liss, Inc.