Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Area of Science:

• Pediatrics
• Neonatology
• Respiratory Medicine

Background:

• Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants, affecting long-term respiratory health.
• Understanding the trajectory of lung function in these infants is crucial for optimizing care and predicting outcomes.

Purpose of the Study:

• To examine the longitudinal changes in lung function in preterm infants with and without BPD.
• To identify perinatal factors associated with lung function indexes in later infancy.

Main Methods:

• Longitudinal lung function assessments were conducted at 6, 12, 18, and 24 months corrected age in 121 preterm infants (61 without BPD, 60 with BPD).
• Perinatal characteristics were analyzed to determine their influence on lung function.

Main Results:

• All preterm infants had reduced lung function at 6 months, but only those with BPD showed persistent deficits after adjusting for body length.
• Infants with mild to moderate BPD showed gradual lung function improvement, while severe BPD cases exhibited persistent poor performance, particularly in forced expiratory flow, up to 24 months.
• Body length z-score and duration of positive-pressure ventilation were identified as major determinants of later infant lung function.

Conclusions:

• Infants with BPD experience prolonged lung function impairment, with severity correlating to long-term outcomes.
• Early perinatal factors, including ventilation support and growth, significantly impact the respiratory trajectory of preterm infants.