Characteristics and outcomes of infants with bronchopulmonary dysplasia discharged on home oxygen at Charlotte Maxeke Johannesburg Academic Hospital, South Africa.

BACKGROUND: Bronchopulmonary dysplasia (BPD) poses a considerable burden of disease in preterm infants, with incidence rising as survival of preterm infants improves. Home oxygen plays a role in the management of infants with BPD, allowing for earlier hospital discharge while requiring supplemental oxygen. OBJECTIVES: To describe the incidence, clinical characteristics and outcomes of infants with BPD at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa, focusing on those discharged on home oxygen. A secondary objective was to compare characteristics of infants discharged on home oxygen with those discharged on room air. METHODS: A retrospective descriptive study of infants diagnosed with BPD was conducted at CMJAH between 1 January 2015 and 31 December 2021. Clinical features, respiratory support and outcomes were described and compared between infants discharged on home oxygen and those discharged on room air. RESULTS: Among 866 infants, the incidence of BPD was 9.8% overall and 28.1% in very low-birthweight infants. Most cases (93.5%) were mild to moderate. Home oxygen use was low (2.1%), and systemic steroid use was high at 59.4%. Infants discharged on home oxygen had a longer hospital stay (85.1 days v. 58.3 days, p<0.001) and higher discharge weight (2 528 g v. 1 834 g, p<0.001). No significant differences in perinatal factors and comorbidities were found. By 1 year corrected age, 54.5% of those on home oxygen had been weaned off it, and 33.3% had had readmissions, mainly for respiratory tract infections. CONCLUSION: The incidence of BPD is increasing locally, but home oxygen use remains low compared with high-income countries. Limited uptake may contribute to prolonged hospitalisation. Development of local guidelines and prospective evaluation of home oxygen use are needed to optimise outcomes and reduce the healthcare burden in resource-limited settings. STUDY SYNOPSIS: What the study adds. Our study showed a high incidence of bronchopulmonary dysplasia (BPD), exceeding earlier local rates but remaining below those of high-income countries. Notably, home oxygen use was low. Infants discharged on home oxygen had longer hospital stays than those discharged on room air, and no clear predictors for home oxygen use were identified.Implications of the findings. Development of standardised local protocols for home oxygen use in infants with BPD is essential. Earlier integration of home oxygen into management plans should be considered, as timely initiation may facilitate shorter hospital stay.