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Comparative analysis of pulmonary function in children born preterm and full-term at 6-9 years of age
Ana Damaris Gonzaga1, Josy Davidson1, Ana Lucia Goulart1
1Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Insights
Children born preterm exhibit significantly higher rates of altered pulmonary function, including increased airway resistance and reduced expiratory flow, compared to full-term infants. These findings highlight long-term respiratory health implications for preterm birth.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Physiology
Background:
- Preterm birth is associated with increased risk of respiratory morbidities.
- Long-term pulmonary function in preterm children requires further investigation using standardized reference values.
Purpose of the Study:
- To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm versus full-term.
- To utilize Global Lung Initiative (GLI) reference values for accurate assessment.
Main Methods:
- Cross-sectional study involving 6-9-year-old children.
- Measurements included airway resistance (Rint) and spirometry.
- Children were categorized into preterm (<37 weeks gestation, <2000g birth weight) and full-term groups, matched for age and sex.
Main Results:
- Preterm children showed significantly higher prevalence of altered airway resistance (16.1% vs 1.8%) and spirometry (26.8% vs 13.4%) compared to full-term children.
- Preterm group had higher Z scores for airway resistance and lower Z scores for FEV1/FVC and FEF25-75.
- No significant differences were observed in Forced Vital Capacity (FVC) Z scores between groups.
Conclusions:
- Preterm children demonstrate a higher prevalence of abnormal pulmonary function compared to their full-term peers.
- Airway resistance is elevated, while expiratory flow rates (FEV1/FVC, FEF25-75) are reduced in preterm-born children.
- These findings underscore the lasting impact of preterm birth on respiratory health.
Objective:
To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values.
Methods:
This is a cross-sectional study with 6-9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered.
Results:
A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones.
Conclusions:
Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term.
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