New BPD predicts lung function at school age: Follow-up study and meta-analysis

Area of Science:

• Pediatric Pulmonology
• Neonatology
• Public Health

Background:

• Advances in neonatal care have improved survival rates for very preterm infants.
• Bronchopulmonary dysplasia (BPD) remains a significant complication, potentially affecting long-term respiratory health.
• The impact of prematurity and BPD on lung function in school-aged children born during the surfactant era requires further investigation.

Purpose of the Study:

• To determine if preterm birth, BPD, and BPD severity predict lung function in school-aged children.
• To assess the long-term pulmonary consequences of prematurity and BPD in the current treatment era.
• To synthesize current evidence through a meta-analysis.

Main Methods:

• A cohort study of 88 school-aged children born very preterm (<32 weeks gestational age) and 88 matched term-born controls.
• Pulmonary function tests including spirometry (measuring forced expiratory volume in 1 second - FEV1) and diffusion capacity (DLCO).
• Meta-analysis of studies published during the antenatal corticosteroid and surfactant treatment era.

Main Results:

• Preterm children exhibited significantly lower FEV1 and DLCO compared to term controls.
• Children with BPD showed reduced FEV1 and DLCO compared to those without BPD.
• Meta-analysis confirmed persistent reductions in FEV1 associated with BPD severity, with moderate to severe BPD linked to a -17.8% difference from term controls.

Conclusions:

• Adverse effects of prematurity on lung function persist into school age.
• Bronchopulmonary dysplasia is associated with significant, long-term reductions in spirometry and diffusion capacity.
• Novel interventions are necessary to mitigate the lifelong respiratory health consequences of preterm birth and BPD.