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Respiratory health and lung function in 8-year-old children of very low birth weight: a cohort study
W H Kitchen1, A Olinsky, L W Doyle
1Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia.
Insights
Very low birth weight children experienced more early respiratory issues. However, lung function at age 8 was generally normal and not linked to prematurity complications after accounting for birth weight.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Neonatology
Background:
- Very low birth weight (VLBW) infants face increased risks for respiratory problems.
- Long-term respiratory outcomes in VLBW survivors require further investigation.
Purpose of the Study:
- To assess respiratory health and lung function at 8 years of age in VLBW children.
- To determine the impact of prematurity complications on long-term respiratory outcomes.
Main Methods:
- Compared respiratory health and lung function between VLBW and normal birth weight children at 8 years.
- Utilized univariate and adjusted analyses to evaluate factors like bronchopulmonary dysplasia and neonatal ventilation.
Main Results:
- VLBW children had more wheezing and hospital readmissions in the first 2 years.
- At 8 years, lung function was generally normal; bronchopulmonary dysplasia and neonatal ventilation effects were confounded by birth weight.
- Asthma or recurrent bronchitis, but not passive smoking, were linked to reduced flow rates.
Conclusions:
- While VLBW is associated with early respiratory issues, lung function at 8 years is largely preserved.
- Adjusting for birth weight is crucial when assessing the impact of perinatal factors on respiratory health.
- Long-term respiratory effects of smoking and perinatal events in VLBW survivors need continued study.
Abstract:
In comparison with a cohort of normal birth weight children, those of very low birth weight (less than 1501 g birth weight) had more wheezing illnesses and hospital readmissions for respiratory problems in the first 2 years of life; from 2 years to 8 years of age respiratory health was unrelated to birth weight. Lung function measurements at 8 years of age in very low birth weight children were similar to expected values; few children had severely abnormal lung function. On univariate analyses, forced vital capacity (FVC) and forced expired volume in 1 second (FEV1), but not flow rates, were lower in children who had survived bronchopulmonary dysplasia. However, the univariate analyses were misleading, because bronchopulmonary dysplasia occurred more frequently with lower birth weight, and lower birth weight in turn was strongly related to reduced FVC and FEV1. After adjusting for birth weight and other potential confounding variables, FVC and FEV1 were unrelated to bronchopulmonary dysplasia, and to neonatal ventilation. Flow rates were largely uninfluenced by perinatal events, but were reduced in children with asthma or recurrent bronchitis at 8 years of age. Passive smoking was unrelated to lung function at 8 years of age. However, the effects of passive or active smoking, or perinatal events, on respiratory function or health beyond 8 years of age in very low birth weight survivors remain to be determined.