[Lung Function in Childhood and Adolescence: Influence of Prematurity and Bronchopulmonary Dysplasia]

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Respiratory Physiology

Background:

• Advances like prenatal steroids and surfactant therapy improve survival for very preterm infants.
• However, prenatal factors, prematurity extent, and bronchopulmonary dysplasia (BPD) may impact long-term pulmonary function.
• Evidence suggests potential effects on lung function during childhood and adolescence.

Purpose of the Study:

• To review pulmonary function outcomes in infants born before 32 weeks gestation in the surfactant therapy era.
• To evaluate the influence of factors like chorioamnionitis, IUGR, maternal metabolic syndrome, prematurity, and BPD on long-term pulmonary function.

Main Methods:

• Comprehensive literature review focusing on pulmonary function after premature birth (<32 weeks gestation).
• Analysis of studies published during the surfactant replacement therapy era.
• Evaluation of specific prenatal and postnatal factors impacting lung function.

Main Results:

• Significant airflow reduction observed in some children and adolescents born very preterm.
• Bronchial obstruction is often not fully reversible with bronchodilators.
• Pulmonary function impairment correlates with BPD severity; diffusion capacity abnormalities can occur even with moderate BPD.
• Intrauterine growth retardation (IUGR) negatively impacts later pulmonary function.
• Limited data exists on chorioamnionitis and maternal metabolic syndrome effects.

Conclusions:

• Infants born before 32 weeks gestation remain at increased risk for impaired pulmonary function in childhood/adolescence, particularly those with BPD.
• Long-term pulmonary care should be managed in specialized centers for optimal outcomes.
• Early identification and management are crucial for mitigating long-term respiratory sequelae.