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The changing incidence of chronic lung disease
1Liverpool Maternity Hospital.
Insights
Chronic lung disease in premature infants increased in the late 1980s, particularly in males and those with low gestation and birthweight. Despite decreased mortality, this trend necessitates increased specialized care for high-risk neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Public Health
Background:
- Chronic lung disease (CLD) is a significantcomplication in premature infants.
- Neonatal intensive care units (NICUs) manage high-risk premature infants.
- Understanding CLD incidence trends is crucial for resource allocation.
Purpose of the Study:
- To examine the incidence of chronic lung disease in premature infants over a decade.
- To identify risk factors associated with CLD development.
- To analyze changes in CLD mortality and incidence in high-risk infants.
Main Methods:
- Retrospective analysis of 242 premature infants admitted to NICU from 1980-1989.
- Data collected included gestation, birthweight, sex, survival, and ventilatory support.
- Logistic regression used to identify significant associations with CLD.
Main Results:
- CLD incidence increased, with one-third of cases occurring in 1988-1989.
- Significant risk factors for CLD included male sex, low birthweight, low gestation, and survival to discharge.
- Mortality in high-risk infants decreased, while incidence significantly increased.
Conclusions:
- CLD incidence rose in the late 1980s, not fully explained by population changes.
- Increased incidence and decreased mortality in high-risk infants suggest evolving management or reporting.
- Anticipate a growing need for specialized follow-up care for these infants.
Abstract:
This paper reports an examination of the incidence of chronic lung disease in premature infants admitted to the neonatal intensive care unit at Liverpool Maternity Hospital. From January 1980 to December 1989 details were obtained for these infants such as gestation, weight, sex, survival to discharge and ventilatory support received. The findings show that a total of 242 infants had developed chronic lung disease; one-third of these were born in 1988 or 1989. Logistic regression suggests that chronic lung disease was significantly associated with being male, low birthweight, low gestation, surviving to discharge, and being born in 1988 or 1989. Among infants at 'high risk' of this condition, mortality had significantly decreased and the incidence had significantly increased. This increase is not fully explained by changes in the population admitted during the last decade. A rising workload should be anticipated in terms of the specialised follow-up and care required by these babies.