What are the long-term health outcomes in low birth weight and premature babies born with chronic lung disease who are discharged home on oxygen?

Date of Approval
Application Number
16_189
Technical Summary

In recent decades advances in neonatal intensive care, such as the introduction of antenatal corticosteroid treatment, surfactant administration and improved respiratory support, have led to improvements in the survival of very premature and low birth weight infants. However, chronic lung disease (CLD) remains a major complication of prematurity and low birth weight, and is associated with many short, medium and long-term morbidities, and increased mortality. Despite the growing number of premature and very low birth weight (VLBW) babies surviving into childhood, there are relatively few recent, nationally-representative studies of health outcomes and use of healthcare resources in this group. Using data collected from CPRD and HES, we propose to use repeated cross-sectional analyses to study the prevalence of VLBW and preterm infants discharged on home oxygen and a retrospective cohort study to identify the medium and long-term morbidities (measures of respiratory health, measures of growth) and healthcare resources used (primary and secondary care consultations, inpatient stays, prescriptions) by this cohort in comparison to preterm and VLBW infants without home oxygen and term infants with normal birthweights. This information will provide an understanding of mechanisms, evolution, and consequences of lung disease in these preterm infants, and is essential in developing prevention strategies as well as in the management of these infants in the neonatal period and beyond.

Health Outcomes to be Measured

Part 1. Need for home oxygen Part 2 . Respiratory outcomes:. Episodes of respiratory tract infection Laboratory tests for infection Diagnosis of asthma; Diagnosis of atopy Length of time oxygen required Other health outcomes: . Measures of growth Healthcare resource use:. Primary care consultation rate overall and for specific conditions such as wheeze and asthma Hospital outpatient consultation rate overall and for a respiratory condition; Hospital inpatient admission rate overall and with a respiratory condition as the primary diagnosis; Number of hospital inpatient bed days and days requiring intensive care; Antibiotic prescriptions in primary care; Prescriptions for respiratory medications in primary care.

Collaborators

Lisa Szatkowski - Chief Investigator - University of Nottingham
Don Sharkey - Collaborator - University of Nottingham
Linda Fiaschi - Collaborator - University of Nottingham
Shin Hui TAN - Collaborator - University of Nottingham
Tricia McKeever - Collaborator - University of Nottingham
William Moreton - Collaborator - University of Nottingham

Linkages

CPRD Mother-Baby Link;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation