CHRONIC LUNG-DISEASE IN VERY-LOW-BIRTH-WEIGHT INFANTS - A 5-YEAR REVIEW

Objectives: To determine the incidence, clinical spectrum and outcome of very low birthweight (VLBW) infants with chronic lung disease (CLD) , and evaluate associated factors. Methodology: Retrospective review o f 265 VLBW infants managed in the NICU from January 1988 to December 1 992. Results: The overall neonatal survival rate for VLBW infants was 83%. Sixty-five (25%) infants had CLD, of whom 42% had severe CLD. Mor tality in infants with CLD was 11%. In contrast with infants without C LD, CLD infants had significantly higher risk of adverse neurodevelopm ent with cerebral palsy documented in 13.5% and functional disability recorded in 34.6% at 2 years corrected age. Factors associated with th e development of CLD included; decreasing birthweight (OR 0.98, CI 0.9 7-0.99), septicaemia (OR 4.96, CI 1.57-15.65), necrotizing enterocolit is (OR 119.07, CI 4.98-2845.04), hyaline membrane disease (OR 5.34, CI 1.83-15.55), patent ductus arteriosus (OR 4.46, CI 1.75-11.36) and in creasing fraction of inspired oxygen concentration in the first week o f life (OR 1.09, CI 1.04-1.14). Conclusions: Chronic lung disease occu rs frequently in VLBW infants and is associated with a high incidence of adverse neurodevelopment. Further studies to clarify the role of no n-respiratory factors such as patent ductus arteriosus (PDA) and sepsi s in the pathogenesis of CLD may reduce the incidence or prevent the d evelopment of CLD in these preterm infants.