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Respiratory function at age 8-9 after extremely low birthweight or preterm birth in Victoria in 1997

Douglas F Hacking1, Anne-Marie Gibson, Colin Robertson

  • 1Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Pediatric Pulmonology
|July 25, 2012
PubMed

Insights

Extremely low birth weight (ELBW) or extremely preterm (EPT) children born in 1997 show persistent respiratory deficits at age 8 compared to normal controls. These lung function impairments, especially in those with bronchopulmonary dysplasia (BPD), mirror earlier findings.

Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Respiratory Medicine

Background:

  • Extremely low birth weight (ELBW) and extremely preterm (EPT) infants face increased risks of respiratory complications.
  • Bronchopulmonary dysplasia (BPD) is a significant risk factor for long-term respiratory morbidity in these vulnerable populations.
  • Previous studies indicated persistent respiratory deficits in ELBW/EPT survivors from earlier birth cohorts.

Purpose of the Study:

  • To assess if respiratory function at 8 years of age in ELBW/EPT children born in 1997 remains impaired compared to normal birth weight (NBW) and term controls.
  • To specifically investigate the impact of neonatal bronchopulmonary dysplasia (BPD) on long-term respiratory outcomes in ELBW/EPT survivors.
  • To compare current findings with historical data from ELBW/EPT children born in 1991-1992.

Main Methods:

  • A cohort study design involving 201 consecutive ELBW/EPT survivors born in Victoria in 1997.
  • 199 contemporaneous NBW/term infants were recruited as randomly selected controls.
  • Respiratory function was assessed at 8 years of age using standardized guidelines, with data available for approximately 75% of participants.

Main Results:

  • ELBW/EPT subjects exhibited significant airflow reductions compared to controls, with mean differences in FEV1 and FEF25-75% mirroring those seen in the 1991-1992 cohort.
  • Children with a history of BPD within the ELBW/EPT cohort showed significant reductions in FEV1 and FEF25-75% compared to ELBW/EPT children without BPD.
  • The observed lung function deficits in ELBW/EPT children born in 1997 were comparable to those from an earlier period with lower survival rates.

Conclusions:

  • ELBW/EPT children born in 1997 continue to experience significantly abnormal lung function at 8 years of age when compared to NBW/term controls.
  • The findings suggest that despite improvements in neonatal care and survival rates, long-term respiratory outcomes for ELBW/EPT survivors have not substantially improved.
  • Neonatal BPD remains a critical determinant of persistent respiratory impairment in extremely preterm and low birth weight survivors.

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