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Diverging effects of premature birth and bronchopulmonary dysplasia on exercise capacity and physical activity - a
Katharina Ruf1, Wolfgang Thomas2,3, Maximilian Brunner2,4
1University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany. ruf_k@ukw.de.
Insights
Bronchopulmonary dysplasia (BPD) in children born extremely preterm is linked to lower exercise capacity, while prematurity itself is associated with reduced physical activity and increased sedentary behavior, regardless of BPD status.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Neonatal Medicine
Background:
- Extreme prematurity is linked to exercise intolerance and reduced physical activity.
- Bronchopulmonary dysplasia (BPD) may exacerbate these issues due to long-term lung function impairments.
Purpose of the Study:
- To compare exercise capacity and habitual physical activity in school-aged children born very/extremely preterm with and without BPD, and term-born children.
- To investigate the independent and combined effects of prematurity and BPD on physical activity and exercise capacity.
Main Methods:
- Included 22 preterm children (8-12 years, <32 weeks gestation, <1500g birthweight; 9 with BPD, 13 without) and 15 healthy term-born controls.
- Assessed habitual physical activity via accelerometry.
- Measured lung function by spirometry and exercise capacity using incremental cardiopulmonary exercise tests.
Main Results:
- Children with BPD showed reduced peak oxygen uptake (83% predicted) compared to those without BPD (91%) and controls (94%).
- BPD status, not prematurity, significantly explained variance in peak oxygen uptake.
- All preterm children exhibited more sedentary behavior and less moderate-to-vigorous physical activity than controls.
- Prematurity, not BPD, significantly contributed to sedentary behavior and reduced physical activity.
Conclusions:
- BPD, not prematurity, was associated with reduced exercise capacity in school-aged children.
- Prematurity, irrespective of BPD, was linked to decreased physical activity and increased sedentary time.
- Findings suggest distinct impacts of prematurity and BPD on children's exercise capacity and activity levels.
Background:
Extreme prematurity has been associated with exercise intolerance and reduced physical activity. We hypothesized that children with bronchopulmonary dysplasia (BPD) would be especially affected based on long-term lung function impairments. Therefore, the objective of this study was to compare exercise capacity and habitual physical activity between children born very and extremely preterm with and without BPD and term-born children.
Methods:
Twenty-two school-aged children (aged 8 to 12 years) born with a gestational age < 32 weeks and a birthweight < 1500 g (9 with moderate or severe BPD (=BPD), 13 without BPD (=No-BPD)) and 15 healthy term-born children (=CONTROL) were included in the study. Physical activity was measured by accelerometry, lung function by spirometry and exercise capacity by an incremental cardiopulmonary exercise test.
Results:
Peak oxygen uptake was reduced in the BPD-group (83 ± 11%predicted) compared to the No-BPD group (91 ± 8%predicted) and the CONTROL group (94 ± 9%predicted). In a general linear model, variance of peak oxygen uptake was significantly explained by BPD status and height but not by prematurity (p < 0.001). Compared to CONTROL, all children born preterm spent significantly more time in sedentary behaviour (BPD 478 ± 50 min, No-BPD 450 ± 52 min, CONTROL 398 ± 56 min, p < 0.05) and less time in moderate-to-vigorous-physical activity (BPD 13 ± 8 min, No-BPD 16 ± 8 min, CONTROL 33 ± 16 min, p < 0.001). Prematurity but not BPD contributed significantly to explained variance in a general linear model of sedentary behaviour and likewise moderate-to-vigorous-physical activity (p < 0.05 and p < 0.001 respectively).
Conclusion:
In our cohort, BPD but not prematurity was associated with a reduced exercise capacity at school-age. However, prematurity regardless of BPD was related to less engagement in physical activity and more time spent in sedentary behaviour. Thus, our findings suggest diverging effects of prematurity and BPD on exercise capacity and physical activity.
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