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Exercise-induced bronchoconstriction in school-age children born extremely preterm
Isabelle Hamon1, Silvia Varechova, Rachel Vieux
1Department of Neonatal Medicine, Regional Maternity Hospital, Nancy, France.
Insights
Children born extremely preterm experience exercise-induced airway obstruction. Prematurity is a key factor, unlike other neonatal complications, impacting their respiratory health at age 7.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Exercise Physiology
Background:
- Children born preterm often exhibit airway hyperresponsiveness.
- Exercise-induced airway responses in preterm children are understudied.
- Understanding exercise effects is crucial for children's daily activities.
Purpose of the Study:
- To characterize airway response to exercise in extremely preterm children.
- To identify determinants of exercise-induced airway changes in this population.
Main Methods:
- Compared 42 preterm children (born <32 wk gestation) with 27 term-born children at age 7.
- Measured spirometry and respiratory impedance pre- and post-exercise.
- Utilized a standardized 6-min treadmill exercise protocol.
Main Results:
- Preterm children demonstrated significant exercise-induced bronchoconstriction.
- Prematurity was identified as a determinant of this response.
- Baseline lung function, neonatal interventions, or maternal smoking did not predict the response.
Conclusions:
- Extremely preterm children show significant exercise-induced airway obstruction at age 7.
- This response differs from asthmatics and suggests non-eosinophilic airway inflammation.
- Highlights the long-term respiratory impact of extreme prematurity.
Background:
School children born preterm often show airway hyperresponsiveness to methacholine or histamine. Less attention has been paid to their airway response to exercise, an important point because of the role of exercise in the child's daily life. The aim of this study was to describe the characteristics of, and potential determinants to, the airway response to exercise in children born extremely preterm.
Methods:
Forty-two nonasthmatic nonatopic children born before 32 wk gestation were compared with 27 healthy nonasthmatic nonatopic term children at age 7. Spirometry and respiratory impedance were measured at baseline and repeated after a single-step 6-min treadmill exercise in a climate-controlled room.
Results:
The preterm group showed significant broncho-constriction induced by exercise. Prematurity, but not low baseline lung function, neonatal oxygen supplementation, mechanical ventilation, chronic lung disease, or maternal smoking, was a determinant of exercise-induced bronchoconstriction.
Conclusion:
Children born extremely preterm present significant exercise-induced airway obstruction at age 7. The response has different characteristics from that occurring in asthmatics and is likely to express airway noneosinophilic inflammation.
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