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Pulmonary function and exercise capacity for ELBW survivors in preadolescence: effect of neonatal chronic lung
Howard W Kilbride1, Mark C Gelatt, Richard J Sabath
1Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO 64108, USA. hkilbride@cmh.edu
Insights
Extremely low birth weight (ELBW) children often have abnormal pulmonary function and reduced exercise capacity, especially those with neonatal chronic lung disease (CLD). These findings highlight the long-term health impacts of preterm birth.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Exercise Physiology
Background:
- Children born extremely preterm (extremely low birth weight [ELBW]) may experience long-term health issues.
- Pulmonary function and exercise capacity are crucial indicators of overall health and well-being.
Purpose of the Study:
- To evaluate the pulmonary function and exercise capacity of children born extremely preterm who appear asymptomatic.
- To compare these outcomes with children born at normal birth weight (NBW).
Main Methods:
- Pulmonary function tests and treadmill exercise tests were conducted on 50 ELBW children (birth weight <801 g) and 25 NBW children, aged 9–15 years.
- Parental questionnaires assessed medical history and physical activity levels.
- Secondary analysis investigated the impact of neonatal chronic lung disease (CLD) on outcomes.
Main Results:
- Twenty percent of ELBW children exhibited clinically abnormal pulmonary function, compared to none in the NBW group (P=.026).
- Pulmonary function differences were primarily linked to ELBW children with a history of CLD.
- ELBW children showed significantly lower oxygen consumption (indicating reduced exercise capacity), irrespective of CLD status (P=.000).
Conclusions:
- ELBW children, particularly those with neonatal CLD, have a higher prevalence of obstructive lung disease abnormalities.
- Reduced oxygen consumption in ELBW children suggests a lower level of physical fitness compared to NBW peers.
Objective:
To assess pulmonary function and exercise capacity of apparently asymptomatic children who were born extremely preterm.
Study Design:
Pulmonary function and treadmill testing were performed on 50 children 9 to 15 years old who had birth weight <801 g (extremely low birth weight [ELBW]) and without apparent neurodevelopmental or pulmonary disabilities, compared with 25 children born at term with normal birth weight (NBW). Medical history and physical activity levels were assessed by parent questionnaire. Group differences were determined by two-sample t test. Secondary analysis was performed to assess significant influence of neonatal chronic lung disease (CLD) on outcome measures.
Results:
Twenty percent of ELBW subjects but no subjects with NBW had clinically abnormal pulmonary function (>2 SD from norms, P=.026). All significant pulmonary function differences except peak expiratory flow rate percentages were accounted for by ELBW subjects who had CLD. Oxygen consumption measurements were significantly lower for subjects with ELBW (30.3+/-6.9 and 38.5+/-5.2 mL/kg/min, P=.000), independent of CLD status.
Conclusion:
Pulmonary function abnormalities consistent with obstructive lung disease were more frequently detected in ELBW children who had neonatal CLD. Low oxygen consumption measurements suggest a lower level of fitness for ELBW children compared with children with NBW.
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