Chronic lung disease in premature infants: a retrospective evaluation of underlying factors.

A retrospective case-control study involving 99 premature infants requiring vigorous respiratory support was conducted to investigate the relative contribution of various etiologic factors in the development of chronic lung disease (CLD). Nineteen of the 99 developed CLD. Background and management factors up to the development of CLD, with attention to mode of ventilation (tube, or face mask/nasal prongs) were investigated. Infants in the CLD group had significantly lower birth weights (BW) (p less than .001) and gestational ages (p less than .01) than those in the non-CLD group. There was no difference in the incidence of intrathoracic airleak or symptomatic patent ductus arteriosus. Of the CLD group, 74% were intubated compared with 35% in the non-CLD group (p less than .002). There was no difference between the groups in the morbidity score of initial pulmonary disease or in the duration of ventilation with various pressures and oxygen concentrations. Multiple logistic regression analysis revealed that intubated infants were 4.8 times more likely to develop CLD than nonintubated infants, and infants with low BW had a 3.2-fold greater risk of developing the disease.