Related Experiment Video
Updated: Nov 15, 2025
Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
Published on: October 31, 2025
Respiratory morbidity in very low birth weight infants through childhood and adolescence
Yoav Littner1,2, Chen Volinsky3,4, Jacob Kuint4,5
1Department of Neonatology, Rambam Health Care Campus, Haifa, Israel.
Insights
Children born at very low birth weight (VLBW) experience higher respiratory issues throughout adolescence. This increased pulmonary morbidity persists from infancy, though it gradually declines with age.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Very low birth weight (VLBW) infants are at increased risk for long-term health complications.
- Respiratory outcomes in VLBW survivors into adolescence require further investigation.
Purpose of the Study:
- To compare the long-term respiratory outcomes up to 18 years of age in children born at very low birth weight (VLBW) versus those born at higher birth weights.
- To assess the persistence and evolution of respiratory morbidity in VLBW individuals throughout childhood and adolescence.
Main Methods:
- An observational, longitudinal, retrospective cohort study was conducted.
- VLBW infants (≤1500g) were compared with matched controls (>1500g) using electronic medical records.
- Pulmonary outcomes included respiratory diagnoses, medication use, specialist visits, and a composite morbidity score.
Main Results:
- The study included 5793 VLBW infants and 11,590 controls born between 1998 and 2012.
- VLBW infants exhibited significantly higher composite respiratory morbidity across all age groups up to 18 years (e.g., RR 1.46 [1.35-1.56] for 12-18 years).
- Respiratory morbidity declined with age in both VLBW and control groups, with lower gestational age impacting morbidity primarily in the first two years.
Conclusions:
- A strong association exists between very low birth weight and persistent pulmonary morbidity into adolescence.
- The elevated respiratory morbidity in VLBW infants is most pronounced in the first year of life and gradually decreases with age.
- These findings highlight the need for ongoing respiratory monitoring in individuals born at very low birth weight.
Objective:
To describe the long-term (up to 18 years of age) respiratory outcomes of children and adolescents born at very low birth weight (VLBW; ≤1500 g) in comparison with that of children born >1500 g.
Methods:
An observational, longitudinal, retrospective study comparing VLBW infants with matched controls, registered at a large health maintenance organization in Israel. Pulmonary outcomes collected anonymously from the electronic medical files included respiratory illness diagnoses, purchased medications for respiratory problems, office visits with either a pediatric pulmonologist or cardiologist and composite respiratory morbidity combining all these parameters.
Results:
Our study included 5793 VLBW infants and 11,590 matched controls born between 1998 and 2012. The majority (99%) of VLBW infants were premature (born < 37 weeks' gestation), while 93% of controls were born at term. The composite respiratory morbidity was significantly higher in VLBW infants compared with controls in all age groups (relative risk [95% confidence interval]: 1 year: 1.22 [1.19-1.26], <2 years: 1.30 [1.27-1.34], 2-6 years: 1.29 [1.27-1.32], 6-12 years: 1.53 [1.47-1.59], 12-18 years: 1.46 [1.35-1.56]; respectively). Both VLBW infants and controls demonstrated a steady decline in the composite respiratory morbidity with aging. In VLBW infants, lower gestational age was associated with higher respiratory morbidity only until 2 years of age and the morbidity declined in each gestational age group until adolescence.
Conclusion:
Our study confirmed a strong association between VLBW and pulmonary morbidity. The higher prevalence of respiratory composite morbidity in VLBW infants persists over the years until adolescence. The respiratory morbidity is most evident in the first year of life and declines afterward.
Related Concept Videos
01:05Breathing
01:17Other Pulmonary Disorders
01:17Pulmonary Cycle: Exhalation
01:31Common Respiratory Disorders
Upper respiratory disorders impact the airways above the vocal cords, encompassing areas like the nose, sinuses, and throat. Various conditions fall under this category, including the common cold and allergic rhinitis. These disorders can stem from several causes,...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...