The Profile of Chronic Lung Disease in <32 Weeks Gestational Age Infants: A Retrospective Cohort Study

Background: Chronic Lung Disease (CLD), also known as bronchopulmonary dysplasia, remains one of the most common complications of prematurity and is associated with prolonged respiratory support and long-term pulmonary morbidity. Known risk factors include prematurity, mechanical ventilation, oxygen exposure, infection, and inflammation. Objective: To determine the incidence of CLD among infants born at <32 weeks’ gestation at Corniche Hospital, characterize associated clinical features, and identify potential risk factors. Methods: This retrospective cohort study included all infants born at <32 weeks’ gestation and admitted to Corniche Hospital between January 1, 2019, and July 31, 2021. Clinical data were extracted from the Cerner™ electronic medical record system and analyzed using inferential statistics including odds ratios, p-values, and confidence intervals. Results: A total of 161 preterm neonates were included. The mean birth weight was 885 ± 283 g, and 57.8% were male. Antenatal corticosteroids were administered in 95% of pregnancies, and 84.5% of infants received surfactant therapy. Overall mortality was 9.3%. In the total study cohort, 112 patients were identified as having CLD with variable severity, 31.1% had mild, 27.3% moderate, and 11.2% severe CLD. Birth weight declined significantly with increasing CLD severity: 810 g (IQR 696–1060), 745 g (IQR 635–952), and 630 g (IQR 572–740) for mild, moderate, and severe disease, respectively (p<0.001). Increasing severity was associated with prolonged ventilation, delayed extubation, longer oxygen dependency, delayed achievement of full enteral feeds, and increased rates of sepsis, inotrope use, and sedation exposure (all p ≤ 0.01). Mortality increased markedly with disease severity, with no deaths in mild CLD compared with 14.3% in moderate and 85.7% in severe CLD (p<0.001). Conclusion: Lower birth weight was strongly associated with escalating CLD severity and mortality. Greater respiratory support requirements, systemic instability, and inflammatory exposure were linked to adverse outcomes, highlighting the importance of early risk stratification and optimized respiratory management in very preterm infants.