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Long-term effects of bronchopulmonary dysplasia on lung function: a pilot study in preschool children's cohort
S Manti1, F Galdo2, G F Parisi1
1AOU Policlinico-Vittorio Emanuele, Respiratory Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Insights
Preschool children born extremely low birth weight (ELBW) show increased small airway resistance, regardless of bronchopulmonary dysplasia (BPD). Shorter gestational age, prolonged oxygen therapy, and sepsis correlate with worse respiratory function in these vulnerable infants.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants, with known long-term effects, yet childhood follow-up data are limited.
- Understanding the respiratory health of extremely low-birth-weight (ELBW) survivors into early childhood is crucial for long-term outcomes.
Purpose of the Study:
- To evaluate the respiratory function of preschool children born preterm with BPD.
- To identify factors associated with respiratory impairment in ELBW infants.
Main Methods:
- Forty-two preterm infants (born <32 weeks gestational age) with BPD were assessed at 3-6 years of age.
- Lung function was measured using impulse oscillometry (IOS), and a health questionnaire was administered.
- Clinical data including gestational age, oxygen use, ventilation, and sepsis were collected.
Main Results:
- No significant lung function differences were found between ELBW children with and without BPD.
- A trend of increased small airway resistance and impedance was observed in all ELBW children.
- Higher rates of gastroesophageal reflux disease were noted in the BPD group.
- Shorter gestational age, longer oxygen supplementation, and sepsis were linked to poorer respiratory function.
Conclusions:
- Respiratory function in ELBW preschoolers is characterized by small airway obstruction, irrespective of BPD status.
- Gestational age, duration of oxygen therapy, and sepsis are key determinants of respiratory health in this population.
Introduction:
Although the long term negative effects of bronchopulmonary dysplasia (BPD) are well known, follow-up studies of preterm infants with BPD into childhood are lacking.
Methods:
Forty-two preschool children (age range 3-6 years) who were born before 32 weeks of gestational age and affected by BPD were enrolled. Pre-, peri-, and post-natal data were collected. During the follow up appointment complete physical examination and lung function (impulse oscillometry (IOS)) were recorded. The European Community Respiratory Health Survey (ECRHS) questionnaire was administered to all enrolled subjects.
Results:
Thirty patients were included in the final analysis. The BPD group did not differ in comparison to the non-BPD group in terms of lung function (p > 0.05). By comparing all subjects enrolled, We detected extremely low-birth-weight (ELBW) infants with height-, weight-, and gender-related reference values and a significant trend of increasing resistance values (R5Hz, R5-20 Hz) and respiratory impedance (Z5Hz) (p < 0.05). No significant difference in bronchial reversibility test was observed among BPD non-BPD groups (p < 0.05). The frequency of gastroesophageal reflux disease was significantly higher in patients with BPD when compared to non-BPD group (p < 0.05). Significant differences in gestational age, oxygen supplementation (days), mechanical ventilation therapy (days), and sepsis between BPD and non-BPD groups were also observed (p < 0.05). There were no significant differences in the prevalence of family and personal history of atopy and/or allergic diseases, tobacco exposure, respiratory symptoms, respiratory syncytial virus bronchiolitis, exercise induced dyspnea, treatment with ß-2 bronchodilators and inhaled corticosteroids among the groups (p > 0.05).
Conclusions:
The respiratory function in preschool children born with ELBW is characterized by an increase in impedance and resistance of small airways. No statistically significant differences were found between ELBW children with BPD and without BPD. With regards to the smallest gestational age, the longer duration of O2 therapy during hospitalization, and sepsis significantly resulted in a worse respiratory function.
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