BRONCHOPULMONARY DYSPLASIA IN INFANTS WITH RESPIRATORY-DISTRESS SYNDROME IN A DEVELOPING-COUNTRY - A PROSPECTIVE SINGLE CENTER-BASED STUDY

The aim of this prospective study was to determine the incidence of br onchopulmonary dysplasia (BPD) in and the outcome of neonates ventilat ed for respiratory distress syndrome (RDS). The study was conducted in a developing country prior to the use of surfactant replacement thera py and the results are compared to published reports from the develope d world. BPD was defined as oxygen dependency beyond day 28 of life. T he incidence of BPD over a 9-month-period was 8.2% of all neonates req uiring ventilation (n = 169) and 41% (n = 38) of neonates ventilated f or RDS (n = 92). Of those neonates who developed BPD, 26% were still b eing ventilated on day 28. Of the infants, 21 (55%) developed type 1 B PD and 17 (45%) type 2 BPD. There was no statistical difference in the severity of lung disease on any of the study days between type 1 and type 2 BPD although neonates with type 2 BPD required assisted ventila tion and supplemental oxygen for a longer period: 30 versus 12 days an d 95 versus 49 days, respectively. Of those neonates who developed BPD , 8 (21%) died prior to discharge from hospital and a further 5 infant s (17%) died subsequent to discharge. Of the latter five, three died f rom treatable causes (gastroenteritis n = 2, pneumonia n = 1), Of the 25 (83%) children seen at follow up, 68% were developing normally, 20% were classified as having suspect development and 12% had developed c erebral palsy at corrected postnatal ages of 12-24 months. None of the results differed significantly from those of neonates being ventilate d in the developed world, except for the causes of post-discharge deat hs. Conclusion Health services providing ventilation for neonates in t he developing world will have to take the needs of children with BPD i nto account when planning a neonatal service which should include amon g others a widely available and easily accessible primary health care system.