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.