Lung abnormalities do not influence aerobic capacity in school children born preterm
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Updated: Dec 2, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Christopher A O'Dea1,2,3, Karla Logie3,4,5, Andrew C Wilson1,2,3,4
1Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia.
Insights
Children born preterm often have lung issues, but their aerobic exercise capacity in childhood is not affected by lung function or structure, even with bronchopulmonary dysplasia (BPD). This finding is crucial for understanding long-term health outcomes in preterm survivors.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Exercise Science
Background:
- Children born preterm frequently exhibit impaired lung function and structural alterations.
- Existing research presents conflicting findings regarding the impact of preterm birth on childhood aerobic exercise capacity.
Purpose of the Study:
- To investigate how neonatal history and bronchopulmonary dysplasia (BPD) influence the relationship between lung function, structure, and aerobic capacity in school-aged children born very preterm.
- To clarify the impact of prematurity on exercise performance in children.
Main Methods:
- A comparative study involving very preterm children (≤32 weeks gestation) with (n=38) and without (n=35) BPD, and term-born controls (n=31) aged 9-12 years.
- Comprehensive lung function tests (spirometry, lung volumes, gas transfer), high-resolution CT scans, and incremental treadmill exercise tests were performed.
Main Results:
- Preterm children with BPD showed an elevated breathing frequency to tidal volume ratio compared to controls (76% vs 63%).
- The majority of preterm children (88%) had detectable structural lung changes on CT scans.
- No significant differences were observed in peak oxygen uptake (V̇O2) or oxygen uptake efficiency slope between preterm children with BPD and term controls, even when corrected for body weight. Severity of lung structural disease did not correlate with exercise outcomes.
Conclusions:
- Children born preterm demonstrate impaired lung function and a high prevalence of structural lung abnormalities.
- Despite abnormal lung function and structure, aerobic exercise capacity in school-aged preterm children is not significantly impacted.
Purpose:
Children born preterm have impaired lung function and altered lung structure. However, there are conflicting reports on how preterm birth impacts aerobic exercise capacity in childhood. We aimed to investigate how neonatal history and a diagnosis of bronchopulmonary dysplasia (BPD) impact the relationship between function and structure of the lung, and aerobic capacity in school-aged children born very preterm.
Methods:
Preterm children (≤ 32 w completed gestation) aged 9-12 years with (n = 38) and without (n = 35) BPD, and term-born controls (n = 31), underwent spirometry, lung volume measurements, gas transfer capacity, a high-resolution computer tomography (CT) scan of the chest, and an incremental treadmill exercise test.
Results:
Children born preterm with BPD had an elevated breathing frequency to tidal volume ratio compared to term controls (76% vs 63%, p = 0.002). The majority (88%) of preterm children had structural changes on CT scan. There were no differences in peak V̇O2 (47.1 vs 47.7 mL/kg/min, p = 0.407) or oxygen uptake efficiency slope when corrected for body weight (67.6 vs 67.3, p = 0.5) between preterm children with BPD and term controls. There were no differences in any other exercise outcomes. The severity of structural lung disease was not associated with exercise outcomes in this preterm population.
Conclusion:
Children born preterm have impaired lung function, and a high prevalence of structural lung abnormalities. However, abnormal lung function and structure do not appear to impact on the aerobic exercise capacity of preterm children at school age.
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