Longitudinal assessment of lung function in extremely prematurely born children
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Published on: August 9, 2024
Jessica Lo1, Sanja Zivanovic2,3, Alan Lunt2,3
1School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia.
Insights
Children born extremely prematurely show persistent small airway dysfunction. Airway obstruction tracked from infancy to adolescence, indicating long-term respiratory health impacts.
Area of Science:
- Pediatric Pulmonology
- Neonatal Respiratory Health
- Longitudinal Lung Function Studies
Background:
- Infants born extremely prematurely often experience respiratory complications.
- Long-term effects of extreme prematurity on small airway function are not fully understood.
- Assessing airway function longitudinally is crucial for understanding disease progression.
Purpose of the Study:
- To longitudinally assess small airway function in children born extremely prematurely.
- To determine if airway function in infancy correlates with function at 11-14 years of age.
- To investigate the tracking of airway obstruction in this population.
Main Methods:
- A longitudinal study involving 35 children born at a mean gestational age of 26 weeks.
- Lung volumes measured using helium gas dilution (FRCHe) and plethysmography (FRCpleth).
- Small airway function assessed via FRCHe:FRCpleth ratio, airway resistance (Raw), FEF75, and FEV1 at 1 year and 11-14 years corrected age.
Main Results:
- The FRCHe:FRCpleth ratio decreased significantly from infancy (0.90) to 11-14 years (0.83).
- A significant annual decrease of 0.54% in FRCHe:FRCpleth was observed, even after adjusting for confounding factors.
- Significant correlations were found between infant airway resistance and adolescent airway function (Raw, FEF75, FEV1).
Conclusions:
- Airway function in children born extremely prematurely demonstrates tracking throughout childhood.
- These findings highlight the persistent impact of extreme prematurity on respiratory health.
- Early assessment of airway function may predict long-term outcomes in extremely preterm infants.
Objectives:
To assess longitudinally small airway function in children born extremely prematurely and whether there was a correlation between airway function in infancy and at 11-14 years.
Working Hypotheses:
There would be tracking of airways obstruction and small airway function would deteriorate during childhood in those born extremely prematurely.
Study Design:
A longitudinal study.
Patient-Subject Selection:
Thirty-five children with a mean gestational age of 26 weeks had lung function assessed at 1 year corrected and 11-14 years of age.
Methodology:
Lung volumes were measured by helium gas dilution (FRCHe ) and plethysmography (FRCpleth ) and small airway function assessed by calculating the FRCHe :FRCpleth ratio. Airway function was assessed at 1 year corrected by measurement of airway resistance (Raw ) and at 11-14 years by assessment of Raw , forced expiratory flow from 75% of vital capacity (FEF75 ), and forced expiratory volume at one second (FEV1 ).
Results:
At the first assessment, the children had a mean (SD) FRCHe :FRCpleth of 0.90 (0.13) and at the second, 0.83 (0.12) (P = 0.035). There was a significant 0.54% decrease (95%CI: -1.02%, -0.06%) in FRCHe :FRCpleth for increased age per year after adjusting for birth weight, gestational age, sex, and bronchopulmonary dysplasia (P = 0.027). There were significant correlations between Raw at the first assessment and Raw (P = 0.012), FEF75 (P = 0.034), and FEV1 (P = 0.04) at 11-14 years.
Conclusions:
These results demonstrate in those born extremely prematurely there is tracking of airway function during childhood.
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