Are regional differences in the rate of chronic lung disease affected by survival rate at different gestational age?–A population based study

Aims: A considerable regional variability in the rate of chronic lung disease (CLD) has been recorded. The aims of the present study were to describe regional differences in the rate of CLD in very preterm neonates from a population-based cohort and to identify the role of survival rate on these findings.

Methods: Out of a total of 4984 preterms <32 weeks, 4185 survived to 36 weeks postmenstrual age (the MOSAIC cohort) in 10 European regions. The regional differences of CLD were reported and associated with mortality in 2 cohorts of 24–27 and 28–31 weeks.

Results: The region specific crude rate of CLD ranged from 10.2% (Italian region) to 24.8% (UK Northern region), mortality rates from 7% (German region) to 20% (Polish region). In 24–27 weeks preterms mortality rate was negatively related with CLD rate (Spearman's rho=0.025), whereas in less immature neonates (28–32 weeks), no association could be demonstrated.

Conclusion: A wide variability of CLD between European regions may be explained by different local practices and partly by different survival rates in most immature preterms.

bronchopulmonary dysplasia - mortality - very preterm neonate