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Are preterm-born survivors at risk of long-term respiratory disease?
Katarzyna Kaczmarczyk1, Ida Wiszomirska2, Magdalena Szturmowicz2
1Head of Physiology Department, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34 Street, Warsaw, Poland.
Insights
Preterm birth may impact female respiratory function long-term. While puberty improved lung function, adult results showed no significant differences, though some parameters were lower in preterm-born individuals.
Area of Science:
- Pulmonology
- Pediatrics
- Obstetrics
Background:
- Preterm birth can have lasting effects on respiratory health.
- Evaluating long-term respiratory function in females born preterm is crucial.
Purpose of the Study:
- To assess the long-term impact of preterm birth on respiratory function in females.
- To determine if preterm birth is associated with poorer spirometric results in adulthood.
Main Methods:
- Spirometric examinations were conducted on 70 preterm-born girls during puberty and a subset were followed up in adulthood after 17 years.
- Adult lung function was compared between the preterm-born group and a reference group.
Main Results:
- Significant improvement in forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and maximal voluntary ventilation (MVV) was observed between adolescent examinations.
- Adult lung function showed no statistically significant differences compared to a reference group, despite lower mean values for FVC and FEV1%pred in the preterm group.
- The preterm group exhibited lower values for forced expiratory flow at 25-75% of FVC (FEF25-75) and FEV1/FVC ratio, with more frequent obstructive disorders, though not statistically significant.
Conclusions:
- Preterm birth may have a lasting negative impact on respiratory parameters in girls.
- Puberty appears to help compensate for the initial negative effects of preterm birth on lung function.
- While adult lung function may not differ significantly, subtle deficits and increased obstructive disorders suggest a continued, albeit not statistically significant, impact of preterm birth.
Background:
To evaluate the long-term impact of preterm birth on respiratory function in female patients born preterm, we undertook spirometric examinations twice, as they reached the age of puberty, then follow-up examinations of part of the same cohort in adulthood. We sought evidence that preterm birth is correlated with poorer spirometric results into adulthood.
Methods:
A total of 70 girls (aged 12.2 ± 1.5 years in 1997) who had been born preterm (at 34.7 ± 1.86 weeks, none having experienced bronchopulmonary dysplasia) took part in spriometric examinations in 1997 and again in 1998. Of those, after a gap of 17 years, a group of 12 were successfully recontacted and participated in the 2015 examination as adults (then aged 27.6 ± 2.6 years, born at 34.5 ± 1.92 weeks). We compared spirometric results across the adolescent and adult examinations, and compared the adult results with an adult reference group.
Results:
The percentage values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity) and MVV (maximal voluntary ventilation) showed significant improvement between the two examinations in the early adolescent period. In adulthood, FEV1%pred (percentage predicted forced expiratory volume in 1 s) showed no statistically significant difference. The mean values of both FVC and FVC%pred (percentage predicted forced vital capacity) for the preterm-born group were lower than for the reference group, but this was not statistically significant. The preterm-born group showed lower values of such parameters as forced expiratory flow at 25-75% of FVC, MEF25 (maximal expiratory flow at 25% of forced vital capacity) and FEV1/FVC as compared with the reference group, but again without statistical significance.
Conclusions:
(1) A somewhat below-norm level of respiratory parameters among preterm-born girls entering pubescence may attest to continued negative impact on their respiratory system. (2) A significant improvement in their spirometric results 1 year later may indicate that pubescence helps compensate for the earlier negative effect of preterm birth. (3) No significant differences were seen in lung function in preterm-born adults as compared with a reference group of adults, although the preterm-born group did exhibit lower values of all parameters studied and more frequent obstructive disorders.
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