Background and aims The improvement of perinatal care has led to significant reduction in perinatal mortality. In our region, there is limited data about prematurity-related outcomes. Therefore, we designed this study to report the in-hospital respiratory morbidities and interventions in VLBWI.

Methods This is a retrospective study of all inborns (Prince Sultan Military Medical City (2004–2012), Riyadh-Saudi Arabia) with a birth weight (b.wt) of <1500 g and gestational age (GA) <34 wks, with no major anomaly. In-hospital respiratory morbidities and interventions were reported. Chronic lung disease (CLD) was defined as requirement of O₂ at 36 wks post-conception.

Results 1262 were included (GA: 28 ± 3 wks, b.wt: 1016 ± 298 g, median length of stay (IQR) was 48d (30–74), survival: 83% and exposure to any antenatal steroid: 79%). Respiratory distress syndrome (RDS), CLD and pneumothorax were diagnosed in 87, 16.3 and 5.9%, respectively. Surfactant, indomethacin and post-natal dexamethasone were used in 67, 23 and 7%, respectively. Surgical ligation of PDA was required in 3% and iNO was used in 9%. The median days on mechanical ventilation, CPAP and O₂ were 2 (0–14),5 (1–21) and 6 (1–36). Males were more likely to have worse RDS, pulmonary haemorrhage and also required longer days on O₂ and received more surfactant (all p < 0.05).

Conclusions The findings of this study suggest that our population is comparable to that reported in the literature and males are at higher risk. These data would set a baseline for further clinical trials and quality improvement projects in our region.