• Shoo K Lee, Xiang Y Ye, Nalini Singhal, Sarah De La Rue, Abhay Lodha, Prakesh S Shah, and Canadian Neonatal Network.
• Department of Pediatrics, University of Toronto, Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada.
• Am J Perinatol. 2013 Aug 1;30(7):601-6.

ObjectiveTo assess the association between altitudes of neonatal intensive care units (NICU) and the rate of bronchopulmonary dysplasia (BPD) and BPD/death in very preterm infants.Study DesignData from infants born at <33 weeks' gestation admitted to Canadian Neonatal Network during 2008 and 2009 were analyzed. The associations between the altitude of NICU and the BPD and altitude and BPD/death were determined using logistic regression models.ResultsOf 7551 eligible infants, 1540 (20%) were admitted to NICUs at an altitude > 400 m, 3661 (48%) between 86 and 400 m, 2350 (31%) at ≤85 m. The incidences of BPD (21.7% versus 17.2%) and BPD/death (26.2% versus 23.0%) were significantly higher in the infants admitted to NICUs at >400 m altitude versus those ≤400 m altitude (p < 0.01). In multivariable analyses, the adjusted odds ratio was 1.81 (95% confidence interval [CI] 1.05 to 3.12) for BPD and 1.79 (95% CI 1.12 to 2.85) for BPD/death among infants admitted to NICUs at altitude > 400 m compared with NICUs at altitude ≤ 400 m. For each 100-m increase in altitude, the odds increased by 8% for BPD (95% CI 4 to 13%) and 9% for BPD/death (95% CI 5 to 13%); however, the increase was mainly due to increase in BPD.ConclusionFor very preterm infants, higher altitude of NICUs increased the risk of BPD.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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