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Updated: Sep 29, 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
Respiratory Follow Up of the Premature Neonates-Rationale and Practical Issues
Raluca Daniela Bogdan1, Roxana Elena Bohiltea2, Adrian Ioan Toma3,4
1Pediatrics Department, Medicover Hospital, Str. Pechea No. 8, Sector 1, 031056 Bucharest, Romania.
Insights
Former premature infants face lasting respiratory issues like infections and asthma. Structured follow-up programs are crucial for early detection and improved long-term health outcomes for these children.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Premature birth (before 37 weeks gestation) can lead to underdeveloped lung structures and increased susceptibility to respiratory problems.
- Factors contributing to respiratory issues include extrauterine lung development, immaturity-related pathology, infections, mechanical ventilation, and impaired breathing control.
- Late preterm infants share similar long-term pulmonary risks as other former premature infants.
Purpose of the Study:
- To review current knowledge on respiratory conditions in former premature neonates (evaluated after 40 weeks corrected age), excluding chronic lung disease.
- To establish the rationale for implementing structured respiratory follow-up programs for this patient population.
- To highlight the need for standardized data collection and evaluation methods in follow-up programs.
Main Methods:
- A comprehensive literature search was conducted to gather evidence on the long-term respiratory consequences of preterm birth.
- The review synthesized findings related to respiratory infections, recurrent wheezing, asthma, and pulmonary function deficits.
- Analysis focused on identifying risks and proposing solutions for effective patient management.
Main Results:
- Former premature infants exhibit a higher incidence of respiratory infections, particularly viral, in early childhood.
- There is an increased risk of recurrent wheezing and asthma development in this population.
- Reduced pulmonary volumes and impaired airway flows are common long-term respiratory sequelae.
Conclusions:
- Former premature neonates require organized, long-term respiratory follow-up from hospital discharge through adulthood.
- Such programs facilitate early risk detection and timely preventive interventions, enhancing prognosis.
- Standardization of data gathering, clinical assessments, and lung function testing is essential for program efficacy and development.
Abstract:
The aim of the review was to present the state of knowledge about the respiratory pathology in former premature neonates (children that were born preterm-before 37 weeks of gestation-and are examined and evaluated after 40 weeks corrected age) other than chronic lung disease, in order to provide reasons for a respiratory follow-up program for this category of patients. After a search of the current evidence, we found that premature infants are prone to long-term respiratory consequences due to several reasons: development of the lung outside of the uterus, leading to dysmaturation of the structures, pulmonary pathology due to immaturity, infectious agents or mechanical ventilation and deficient control of breathing. The medium- to long-term respiratory consequences of being born before term are represented by an increased risk of respiratory infections (especially viral) during the first years of life, a risk of recurrent wheezing and asthma and a decrease in pulmonary volumes and airway flows. Late preterm infants have risks of pulmonary long-term consequences similar to other former premature infants. Due to all the above risks, premature neonates should be followed in an organized fashion, being examined at regular time intervals from discharge from the maternity hospital until adulthood-this could lead to an early detection of the risks and preventive therapies in order to improve their prognosis and assure a normal and productive life. The difficulties related to establishing such programs are represented by the insufficient standardization of the data gathering forms, clinical examinations and lung function tests, but it is our belief that if more premature infants are followed, the experience will allow standards to be established in these fields and the methods of data gathering and evaluation to be unified.
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