Study of Demographic Characteristics, Management Details and Early Life Outcomes of Indigenous Infants With Chronic Neonatal Lung Disease in North Queensland.

OBJECTIVE

To study the demographic characteristics, risk factors, management details and clinical outcomes to 12 months corrected age in indigenous and non-indigenous infants with chronic neonatal lung disease in North Queensland.

DESIGN

Retrospective cohort study of infants with chronic neonatal lung disease admitted to a tertiary neonatal intensive care unit in regional Queensland from January 2015 to December 2019.

RESULTS

There were 139 infants with chronic neonatal lung disease and 425 controls. The incidence of chronic neonatal lung disease in infants born at < 33 weeks gestational age was 32.6% versus 20.4% in indigenous and non-indigenous infants, respectively (OR 1.8, p value 0.001). Indigenous infants had significantly lower birth weight (830 g vs. 1000 g, p value 0.039), higher rate of maternal smoking during the pregnancy (57.4% vs. 25%, p value < 0.001), were less likely to be inborn (71.4% vs. 88.2%, p value 0.017) or receive adequate course of antenatal corticosteroids (30.2% vs. 59.2%, p value < 0.001), had increased incidence of grade 2 intraventricular haemorrhage (17.5% vs. 4%, p value 0.01) and were more likely to reside in a very remote locality (17.4% vs. 3.9%, p < 0.001). Identified risk factors for chronic neonatal lung disease included lower birth weight (OR 0.99, p value 0.014), lower birth gestation (OR 1.57, p value 0.003), longer duration of continuous positive airway pressure (OR 1.004, p value < 0.001), longer duration of humidified high-flow nasal prongs (OR 1.003, p < 0.001), doses of surfactant (OR 1.55, p value 0.038) and receiving post-natal steroids (OR 19.03, p < 0.001). There were no other significant differences in comorbidities, management, complications, number of hospital admissions or weight to 12-months corrected age.

CONCLUSIONS

Indigenous infants had increased antenatal risk factors for chronic neonatal lung disease and account for a disproportionate number of cases, however, their outcomes to 12 months corrected age were similar to non-indigenous infants.