Background Babies born at extreme gestation are prone to develop complications of prematurity including bronchopulmonary dysplasia (BPD). It is however very difficult to predict babies at risk of being discharged on home oxygen.

Aims To identify the possible contributing factors for chronic oxygen dependency among infants born before 28 weeks gestation.

Methods Babies born before 28 weeks gestation between 2009 and 2011 and discharged home on oxygen (cases) from University Hospital of North Tees were identified. Matched control for gestation as close to the date of birth for each case was then identified from admission register. Demographic and clinical details pre & post discharge were collected for cases & controls and analysis for comparison done using SPSS® version 19.

Results

• The mean gestation 26.5vs.25.6 weeks (p=0.170) and birth weight 915vs.828g (p=0.337) were similar between controls & cases respectively.

• Babies discharged on home oxygen were dependent on oxygen for significantly longer period (62vs.31 days; p=0.007); received prolonged CPAP (25vs.12 days; p=0.01) but difference in duration of mechanical ventilation was not significant (25vs.13 days; p=0.11).

• Peak inspiratory pressures for cases were significantly higher compared to controls (30vs.19mm Hg; p=0.031) but length of hospital stay was not different (87vs.80 days; p=0.477).

• BPD rates (p=0.001) and diuretic use (p=0.029) in home oxygen group was significantly higher.

• The duration of home oxygen therapy was not affected by postnatal complications or respiratory support.

Conclusion Prolonged period of respiratory support, high peak inspiratory pressures and use of diuretics in extreme premature babies is correlated with discharge on home oxygen.