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Lung function in children of low birth weight
K N Chan1, C M Noble-Jamieson, A Elliman
1Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital.
Insights
Children born with low birth weight exhibit reduced airway function by age seven, independent of neonatal illness. Factors like male gender and maternal smoking also impact lung development, suggesting prematurity
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Low birth weight (LBW) and prematurity are associated with long-term respiratory health issues.
- Neonatal respiratory illnesses and treatments may impact childhood lung function.
- Understanding the independent effects of LBW on lung development is crucial.
Purpose of the Study:
- To assess childhood lung function in low birth weight (LBW) children at seven years of age.
- To determine the independent association of LBW with airway function, controlling for neonatal factors.
- To identify other contributing factors to reduced lung function in LBW children.
Main Methods:
- Lung function tests (spirometry) were performed on 130 LBW children and 120 controls at age seven.
- Data on neonatal respiratory illness, oxygen use, and mechanical ventilation were collected.
- Statistical analyses were used to assess the association between LBW, neonatal factors, and lung function.
Main Results:
- LBW children showed significantly reduced forced expiratory volume in 0.75 second and expiratory flow indices compared to controls.
- Reduced airway function in LBW children was independent of neonatal respiratory illness, oxygen therapy, or mechanical ventilation.
- Male gender and maternal smoking were also associated with poorer airway function.
Conclusions:
- Very low birth weight significantly impacts the growth of airway function, independent of neonatal respiratory illness or treatment.
- The long-term effects of neonatal respiratory treatment appear less significant than those of birth weight, maternal smoking, and male sex.
- LBW is a primary determinant of reduced childhood airway function, affecting cough but not necessarily wheeze.
Abstract:
Lung function was recorded in a cohort of 130 age specific children of low birth weight (under 2000 g) and a reference population of 120 unselected local schoolchildren at 7 years of age. Children of the cohort were similar in height and forced vital capacity to the reference group, but had significantly reduced forced expiratory volume in 0.75 second and expiratory flow indices. Although neonatal respiratory illness was associated with reduced airway function, we were unable to confirm that this was a consequence of oxygen treatment or mechanical ventilation. Low birth weight, however, was closely associated with poor airway function independent of neonatal respiratory illness. Other factors of importance included the male gender and maternal smoking. The reduction in airway function observed in the low birthweight children was associated with cough but not wheeze. The disparity between the relatively well preserved vital capacity and reduced airway function suggests that very low birth weight, and hence prematurity, has its greatest effect on the subsequent growth of airway function. The absence of an association between neonatal oxygen score or mechanical ventilation and childhood lung function suggests that the long term effect of neonatal respiratory treatment is small compared with that of birth weight, maternal smoking, and male sex.