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Perinatal factors associated with long-term respiratory sequelae in extremely low birthweight infants

Katsuya Hirata1, Masahiro Nishihara1, Jun Shiraishi1

  • 1Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|March 19, 2015
PubMed

Insights

Extremely low birthweight survivors with bubbly/cystic lung appearances as neonates show impaired lung function at age 8. Neonatal lung imaging is crucial for predicting long-term respiratory outcomes in these vulnerable children.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Developmental Pediatrics

Background:

  • Extremely low birthweight (ELBW) survivors face increased risks of respiratory complications.
  • Long-term lung function assessment in ELBW infants is essential for understanding developmental trajectories.
  • Identifying perinatal predictors of impaired lung function can inform early interventions.

Purpose of the Study:

  • To evaluate lung function at 8 years of age in extremely low birthweight (ELBW) survivors.
  • To identify perinatal factors associated with diminished lung function in this cohort.

Main Methods:

  • Retrospective cohort study of ELBW survivors born between 1990 and 2004.
  • Spirometry was performed at 8 years of age; children with IQ <70 were excluded.
  • Multivariate logistic regression analyzed perinatal determinants of airway obstruction (FEV1/FVC ratio <80%).

Main Results:

  • Of 656 ELBW survivors, 201 completed lung function tests at 8 years.
  • A bubbly/cystic lung appearance on neonatal X-ray was significantly associated with a low FEV1/FVC ratio (OR 4.84).
  • This lung morphology correlated with indicators of immaturity and intrauterine inflammation.

Conclusions:

  • Neonatal bubbly/cystic lung appearance is a strong predictor of reduced forced expiratory volume in 1 second/forced vital capacity ratio at school age.
  • These findings highlight the importance of neonatal lung imaging in predicting long-term respiratory health in ELBW survivors.
  • Early signs of lung immaturity and inflammation in neonates may predispose to persistent airway obstruction.
Abstract

Keywords:
NeonatologyRespiratory

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