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Long term respiratory outcomes of very premature birth (<32 weeks)

Anne Greenough1

  • 1Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, London, UK.

Seminars in Fetal & Neonatal Medicine
|February 4, 2012
PubMed

Insights

Very premature infants often develop bronchopulmonary dysplasia (BPD), leading to long-term respiratory issues and hospitalizations. This condition, even in its

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a common complication in very prematurely born infants, often resulting in prolonged oxygen dependence and recurrent respiratory symptoms.
  • Traditional 'classical' BPD data primarily reflects outcomes in infants with severe neonatal respiratory failure.
  • A 'new' BPD phenotype is emerging, characterized by chronic oxygen dependence despite initially mild respiratory distress.

Purpose of the Study:

  • To describe the respiratory outcomes and morbidity associated with 'new' BPD in extremely preterm infants.
  • To investigate the long-term respiratory sequelae in adults who experienced extreme prematurity and BPD.
  • To identify factors influencing respiratory morbidity, including respiratory syncytial virus (RSV) infections.

Main Methods:

  • Review of existing data on adolescents and adults with a history of extreme prematurity and BPD.
  • Analysis of respiratory symptoms, lung function abnormalities, and rehospitalization rates.
  • Correlation of respiratory outcomes with the type of BPD ('classical' vs. 'new') and history of lower respiratory tract infections.

Main Results:

  • Infants with 'new' BPD experience chronic respiratory morbidity and potential lung function decline within the first year.
  • Respiratory syncytial virus (RSV) lower respiratory tract infections are linked to increased rehospitalization and chronic respiratory morbidity.
  • These findings suggest that premorbid lung function may influence susceptibility to infections and subsequent morbidity.

Conclusions:

  • Extreme prematurity, particularly with 'new' BPD, leads to significant long-term respiratory morbidity.
  • Early lung injury and infections like RSV contribute to adverse respiratory outcomes in this vulnerable population.
  • Understanding these outcomes is crucial for improving long-term respiratory health management in survivors of extreme prematurity.

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