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Lung function and exercise capacity in young adults born prematurely
Elianne J L E Vrijlandt1, Jorrit Gerritsen, H Marike Boezen
1Department of Pediatric Pulmonology, Beatrix Children's Hospital Groningen, The Netherlands. e.j.l.e.vrijlandt@bkk.umcg.nl
Insights
Young adults born prematurely exhibit persistent airway obstruction and reduced diffusing capacity, impacting exercise capacity. These long-term effects of prematurity highlight the need for continued monitoring.
Area of Science:
- Pulmonary Medicine
- Pediatric Health
- Exercise Physiology
Background:
- Limited data exists on long-term lung function and exercise capacity in adults born prematurely.
- Prematurity can impact respiratory and cardiovascular development, with potential lasting consequences.
Purpose of the Study:
- To assess the long-term effects of prematurity on lung function and exercise capacity.
- To compare ex-preterm young adults with healthy term-born peers.
Main Methods:
- Prospective cohort study following children born before 32 weeks gestation or <1500g for 19 years.
- Lung function tests (spirometry, bodybox, diffusing capacity) and bicycle ergometer tests were performed.
- 42 ex-preterm participants and 48 healthy controls were evaluated.
Main Results:
- Ex-preterm adults showed significantly lower FEV1, diffusing capacity of the lungs for carbon monoxide (DLCO)sb, and exercise capacity compared to controls.
- Total lung capacity (TLC) and peak oxygen consumption (Vo2) did not differ between groups.
- No significant differences were observed in lung function or exercise parameters between preterms with or without bronchopulmonary dysplasia.
Conclusions:
- Prematurity is associated with long-term airway obstruction and reduced CO diffusing capacity, though lung function often remains within normal ranges.
- Ex-preterm individuals exhibit lower exercise capacity, potentially linked to impaired physical fitness rather than solely lung function deficits.
- These findings underscore the lasting impact of prematurity on respiratory health and physical performance into adulthood.
Rationale:
Limited information is available about the long-term outcome of lung function and exercise capacity in young adults born prematurely.
Objective:
To determine long-term effects of prematurity on lung function (volumes, diffusing capacity) and exercise capacity in ex-preterms compared with healthy peers.
Methods:
In a prospective cohort study, children born with a gestational age of less than 32 wk and/or a birth weight under 1,500 g were followed up for 19 yr. Participants (n=42; mean gestational age, 30 wk, and mean birth weight, 1,246 g) and healthy term control subjects (n=48) were recruited for lung function and exercise tests.
Measurements:
Spirometry, bodybox (TLC(box)), diffusing capacity (Dl(CO)), bicycle ergometer test.
Main Results:
Preterm birth was associated with lower FEV(1) (preterms, 95% predicted, vs. controls, 110% predicted; p<0.001), DL(CO)sb (88% predicted vs. 96% predicted, p=0.003), and exercise capacity (load, 185 vs. 216 W; p<0.001; anaerobic threshold: mean, 1,546 vs. 1,839 ml/min; p<0.001) compared with control subjects at follow-up. No differences between the groups were found in TLC(box), peak oxygen consumption (Vo(2)), and breathing reserve. No significant differences in lung function and exercise parameters were found between preterms with and without bronchopulmonary dysplasia.
Conclusions:
Long-term effects of prematurity were airway obstruction and a lower CO diffusing capacity compared with control subjects, although mean lung function parameters were within the normal range. Ex-preterms had a lower exercise level, which could not be explained by impaired lung function or smoking habits, but might be due to impaired physical fitness.
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