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Pulmonary function in former very low birth weight preterm infants in the first year of life
Daniela de Melo Miranda Gonçalves1, Gustavo Falbo Wandalsen2, Ana Sílvia Scavacini1
1Department of Pediatrics, Neonatal Division of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
Insights
Former preterm infants show compromised pulmonary function, with prematurity and respiratory support being key factors. Early assessment is crucial for identifying and managing these long-term respiratory issues in infants.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Respiratory Physiology
Background:
- Pulmonary function in infants born prematurely may be impaired during childhood.
- Very-low-birth-weight infants are at higher risk for respiratory complications.
- Early identification of pulmonary issues in preterm infants is critical for long-term health outcomes.
Purpose of the Study:
- To evaluate the pulmonary function of very-low-birth-weight preterm infants at 6-12 months of corrected age.
- To identify factors associated with abnormal pulmonary function in this cohort.
- To compare pulmonary function between preterm infants and a control group of term-born infants.
Main Methods:
- A cross-sectional study involving preterm infants (<1500g birth weight) and term-born controls.
- Pulmonary function assessed using spirometry (chest compression technique) and total body plethysmography.
- Exclusion of infants with malformations or neuromuscular/respiratory diseases.
Main Results:
- Preterm infants exhibited significantly lower pulmonary function parameters (FVC, FEV0.5, FEF50, FEF75, FEF25-75) compared to term infants.
- 39.2% of preterm infants had abnormal lung function, versus 0% in the control group.
- Lower gestational age, small for gestational age, mechanical ventilation, and recurrent wheezing were linked to abnormal pulmonary function.
Conclusions:
- Preterm infants demonstrate a high prevalence of abnormal pulmonary function compared to term infants.
- Factors such as prematurity, intrauterine growth restriction, respiratory support, and recurrent wheezing are associated with impaired lung function.
- These findings highlight the need for ongoing monitoring and intervention for preterm infants' respiratory health.
Background:
Pulmonary function in former preterm infants may be compromised during childhood.
Objectives:
To assess pulmonary function in very-low-birth-weight preterm infants at 6-12 months of corrected age and analyze the factors associated with abnormal pulmonary function.
Methods:
Cross-sectional study with preterm infants at 6-12 months of corrected age with birth weight <1500 g. Children with malformations or affected by neuromuscular and respiratory diseases were excluded. Forced expiratory flows were assessed using the chest compression technique, and volumes were measured by total body plethysmography. Pulmonary function parameters in preterm infants were compared to a control group of same-aged children born at term.
Results:
We studied 51 preterm and 37 infants born at term. Preterm infants had: gestational age at birth (30.0 ± 2.5 weeks), birth weight (1179 ± 247 g), 27.5% had bronchopulmonary dysplasia, and 45% received mechanical ventilation. Preterm infants had lower median z-scores in comparison to term infants for the following parameters (p < 0.05): FVC (-0.3 vs. 0.7), FEV0.5 (-0.5 vs. 0.9), FEV0.5/FVC (-0.6 vs. -0.5), FEF50 (-0.4 vs. 0.9), FEF75 (-0.3 vs. 0.8), FEF85 (-0.1 vs. 0.6) and FEF25-75 (-0.5 vs. 1.1). No term child had abnormal lung function, compared to 39.2% of preterm infants (p = 0.001). Factors associated with abnormal pulmonary function were lower gestational age at birth, small for gestational age, need for mechanical ventilation and presence of recurrent wheezing.
Conclusions:
Preterms had a high prevalence of abnormal pulmonary function and lower pulmonary function in comparison to term infants. Prematurity, intrauterine growth restriction, respiratory support and recurrent wheezing were associated with abnormal pulmonary function.
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