Lung function and exercise capacity in prematurely born young people

Area of Science:

• Pediatric pulmonology
• Exercise physiology
• Neonatal care

Background:

• Infants born very prematurely often experience lung function abnormalities.
• Antenatal corticosteroids and postnatal surfactant are common treatments for premature infants.
• The long-term impact of these lung abnormalities on exercise capacity in young adulthood is not fully understood.

Purpose of the Study:

• To investigate the association between lung function abnormalities and reduced exercise capacity in young adults born very prematurely.
• To determine if exposure to antenatal corticosteroids and postnatal surfactant influences this association.

Main Methods:

• Follow-up study of 126 young people (mean gestational age 27 weeks) from the UKOS cohort, assessed at a mean age of 17 years.
• Lung function was assessed using spirometry (FEF75, FEV1, FVC, RV, FRCpleth), with abnormalities defined as below the 5th centile.
• Exercise capacity was measured via a modified shuttle sprint test and self-reported daily exercise duration.

Main Results:

• Abnormal forced expiratory flow at 75% (FEF75) was present in 39 participants, associated with an 114m reduction in sprint distance and 0.73 hours less self-reported exercise.
• Very abnormal FEF75 (n=27) was linked to a 159m reduction in sprint distance and 1.15 hours less self-reported exercise.
• These associations remained statistically significant after adjustments.

Conclusions:

• Young adults born very prematurely with abnormal airway function demonstrate significantly reduced exercise capacity.
• Impaired lung function, particularly reduced FEF75, is a key factor limiting physical activity in this population.
• These findings underscore the importance of monitoring and potentially intervening for lung health in extremely preterm individuals.