Influence of ethnic origin on respiratory distress syndrome in very premature infants

Aim-To determine whether the incidence of respiratory distress syndrome (RDS) is related to ethnic origin in very premature infants (less than or equal to 32 weeks of gestational age and birthweight less than or equal to 2.0 kg). Method-A retrospective cohort study was performed to determine the incidence of respiratory disorders in African, Caribbean, and caucasian infants. An African infant was matched with two infants (one of Caribbean and one of caucasian descent) for gestational age and birth order and, if several eligible matching infants were found, for gender and approximate birth date. Fifty African infants (median gestational age 28 weeks, range 23-32) were matched with an infant of Caribbean and one of caucasian descent. Results-Compared with the incidence of RDS in African infants (40%), that in caucasian infants (75%) was significantly higher (p<0.05), while the incidence in the Caribbean infants (54%) did not differ significantly. Regression analysis showed that ethnic origin was related to the occurrence of]RDS independent of gestational age, size for dates, antenatal steroids, hypertension during pregnancy, premature rupture of membranes, maternal smoking, mode of delivery and infant gender. Conclusion-The enhanced lung maturation found in certain ethnic groups, even when born prematurely, has implications for clinical management.