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Lifelong pulmonary sequelae of bronchopulmonary dysplasia
Laura Sillers1, Stamatia Alexiou2, Erik A Jensen1
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics.
Insights
Very preterm infants with bronchopulmonary dysplasia (BPD) face ongoing respiratory issues into adulthood. While quality of life is often similar to peers, persistent lung function deficits may increase COPD risk.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- BPD survivors often experience respiratory symptoms and require more medical care in early childhood.
Purpose of the Study:
- To review current literature on long-term pulmonary outcomes in survivors of BPD.
- To assess the pulmonary morbidity associated with BPD over the first two decades of life.
Main Methods:
- Literature review of studies evaluating long-term pulmonary morbidity in very preterm infants with BPD.
- Analysis of respiratory signs, medication use, rehospitalization rates, functional status, and pulmonary function tests.
Main Results:
- BPD is linked to persistent respiratory symptoms, increased medication use, and rehospitalizations in childhood.
- While functional status and quality of life may be similar to non-BPD peers, pulmonary function deficits can persist.
- These deficits may indicate a higher susceptibility to early-onset chronic obstructive pulmonary disease (COPD) in adulthood.
Conclusions:
- BPD diagnosis is associated with significant long-term pulmonary morbidity.
- Further longitudinal studies are necessary to understand if current BPD survivors face increased risks of adult pulmonary disease.
Purpose Of Review:
To summarize the current literature evaluating long-term pulmonary morbidity among surviving very preterm infants with bronchopulmonary dysplasia (BPD).
Recent Findings:
BPD predisposes very preterm infants to adverse respiratory signs and symptoms, greater respiratory medication use, and more frequent need for rehospitalization throughout early childhood. Reassuringly, studies also indicate that older children and adolescents with BPD experience, on average, similar functional status and quality of life when compared to former very preterm infants without BPD. However, measured deficits in pulmonary function may persist in those with BPD and indicate an increased susceptibility to early-onset chronic obstructive pulmonary disease during adulthood. Moreover, subtle differences in exercise tolerance and activity may put survivors with BPD at further risk of future morbidity in later life.
Summary:
Despite advances in neonatal respiratory care, a diagnosis of BPD continues to be associated with significant pulmonary morbidity over the first two decades of life. Long-term longitudinal studies are needed to determine if recent survivors of BPD will also be at increased risk of debilitating pulmonary disease in adulthood.
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