Lung function at term in extremely preterm-born infants: a regional prospective cohort study

Area of Science:

• Neonatology
• Pediatric Pulmonology
• Respiratory Physiology

Background:

• Extremely preterm (EP) infants often experience respiratory complications.
• Bronchopulmonary dysplasia (BPD) is a common chronic lung disease in premature infants.
• Assessing lung function early is crucial for predicting long-term respiratory health.

Purpose of the Study:

• Compare lung function in EP infants (with and without BPD) to term-born infants.
• Identify perinatal factors associated with lung function at term-equivalent age.
• Evaluate the predictive value of early lung function for later respiratory morbidity in EP infants.

Main Methods:

• Prospective recording of perinatal variables.
• Tidal breathing parameters measured at term-equivalent age using electromagnetic inductance plethysmography.
• Respiratory morbidity defined by readmissions or asthma medication use in the first year.

Main Results:

• EP infants (with and without BPD) exhibited significant airway obstruction, higher tidal volumes, and increased minute ventilation compared to term infants.
• Male gender, antenatal steroids, and duration of continuous positive airway pressure were linked to lung function.
• A predictive model incorporating tidal breathing, BPD status, birth weight z-score, and gender accurately predicted first-year respiratory morbidity (AUC 0.818).

Conclusions:

• Lung function at term-equivalent age is significantly impaired in EP infants, even without BPD.
• Tidal breathing parameters show promise for predicting future pulmonary health in premature infants.