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Changes in lung function between age 8 and 14 years in children with birth weight of less than 1,501 g
L W Doyle1, R Chavasse, G W Ford
1Department of Obstetrics and Gynaecology, University of Melbourne, Australia.
Insights
Lung function in children born with very low birth weight (<1,501 g) improved significantly between ages 8 and 14. These improvements in lung function were most pronounced in extremely low birth weight infants (<1,000 g).
Area of Science:
- Pediatrics
- Pulmonology
- Neonatology
Background:
- Children born with very low birth weight (<1,501 g) may experience altered lung development.
- Longitudinal data on lung function changes in this cohort from childhood to adolescence are limited.
Purpose of the Study:
- To assess changes in lung function relative to predicted values in children with birth weights <1,501 g between ages 8 and 14 years.
- To investigate if changes in lung function differ between infants with birth weights <1,000 g and those between 1,000-1,500 g.
Main Methods:
- Longitudinal study of children born at the Royal Women's Hospital, Melbourne.
- Inclusion of 86 survivors with birth weights <1,000 g and 124 survivors with birth weights 1,000-1,500 g.
- Measurement of lung function (including forced expired volume in 1 second, FEV1) at ages 8 and 14 years, with adjustments for prematurity.
Main Results:
- Overall lung function was comparable to predicted values at both ages 8 and 14 years.
- Significant improvements in lung function, particularly FEV1, were observed between ages 8 and 14 years (mean increase of 6.4% predicted).
- Infants with birth weights <1,000 g showed significantly greater improvements in FEV1 (% predicted) compared to those with birth weights 1,000-1,500 g (10.3% vs 3.3% increase).
Conclusions:
- Lung function significantly improves relative to predicted values in children born with birth weights <1,501 g between ages 8 and 14.
- The most substantial improvements in lung function are observed in the extremely low birth weight subgroup (<1,000 g).
- These findings highlight the dynamic nature of lung development and potential for catch-up growth in survivors of extreme prematurity.
Abstract:
We set out to determine whether lung function of children with a birth weight of <1,501 g changed relative to expectations between the ages of 8 and 14 years. We hypothesized that changes in lung function may differ between those of birth weight above and below 1,000 g. The subjects of this study were born in the Royal Women's Hospital, Melbourne. There were 86 consecutive survivors with birth weights <1,000 g born between January 1, 1977 and March 31, 1982, and 124 consecutive survivors with birth weights 1,000-1,500 g born between October 1, 1980 and March 31, 1982. Lung function was measured at both age 8 and 14 years, corrected for prematurity in 78% (67/86) of those with birth weight <1,000 g, and in 69% (86/124) of those with birth weight 1,000-1,500 g. Overall, lung function was similar to predicted values at both 8 and 14 years of age [e.g., (forced expired volume in 1 s, FEV1% predicted) at age 8 years mean 88.5% (SD 14.7) and at age 14 years, mean 94.9% (SD 13.8)]. There were significant changes, mostly improvements, in lung function between age 8-14 years relative to predicted values: FEV1 (% predicted) increased between 8-14 years of age by a mean of 6.4 (95% confidence interval, 4.4-8.3). The improvements in some lung function variables were significantly greater in those of birth weight <1,000 g compared with those of birth weight 1,000-1,500 g: improvement in FEV1 (% predicted) between age 8-14 years in infants with birth weight <1,000 g had a mean of 10.3 (SD 13.1), and in those with birthweight 1,000-1,500 g a mean of 3.3 (SD 10.1). We conclude that lung function improved significantly relative to predicted values in children of birth weight <1,501 g between age 8-14 years. The improvements were greatest in those of birth weight <1,000 g.