Are Preterm Infants at High Altitude at Greater Risk for the Development of Bronchopulmonary Dysplasia?

Objectives: To assess the association between altitudes of neonatal intensive care units (NICUs) and the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. Methods: Data from infants born at < 32 weeks' gestation admitted to NICUs at high altitude (2200 m above sea level) between 2002 and 2011 were analyzed and compared with the data from a lower altitude NICU in Saudi Arabia. Results: Of 942 preterm infants admitted to the high altitude NICUs, 266 (28.2%) infants developed BPD. The incidence of BPD was significantly higher in infants admitted to the NICU at high altitude than in those at lower altitude (28.2 vs. 17.7%, respectively, p = 0.003). In multivariable analysis, high altitude was significantly associated with a higher risk of BPD (odds ratio: 0.54, 95% confidence interval: 0.36-0.81). Conclusion: Findings suggest that high altitude may increase the risk of BPD development among preterm infants.