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ISRN Pediatrics
Volume 2012 (2012), Article ID 685151, 9 pages
http://dx.doi.org/10.5402/2012/685151
Research Article

Regional Variation on Rates of Bronchopulmonary Dysplasia and Associated Risk Factors

1Department of Clinical Epidemiology and Biostatistics, School of Medicine, Pontificia Universidad Javeriana, Bogotá 110001, D.C., Colombia
2Division of Neonatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
3Division of Research and Information, College of Medicine, Florida International University, Miami, FL, USA

Received 6 March 2012; Accepted 9 May 2012

Academic Editors: G. J. Casimir, D. L. Jeppesen, S. K. Patole, and T. F. Yeh

Copyright © 2012 María Ximena Rojas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective. To identify risk factors that could explain the observed high incidence and regional variations of bronchopulmonary dysplasia. Study Design. A case-control study was designed for testing the hypothesis that differences in the disease rates were not explained by differences in city-of-birth specific population characteristics or by differences in respiratory management practices in the first 7 days of life, among cities. Results. Multivariate analysis showed that premature rupture of membranes, exposure to mechanical ventilation after received nasal CPAP, no surfactant exposure, use of rescue surfactant (instead of early surfactant), PDA, sepsis and the median daily FIO2, were associated with a higher risk of dysplasia. Significant differences between cases and controls were found among cities. Models exploring for associations between city of birth and dysplasia showed that being born in the highest altitude city (Bogotá) was associated with a higher risk of dysplasia (OR 1.82 95% CI 1.31–2.53). Conclusions. Bronchopulmonary dysplasia was manly explained by traditional risk factors. Findings suggest that altitude may play an important role in the development of this disease. Prenatal steroids did not appear to be protective at high altitude.