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An Update on Lung Function of Extremely and Very Preterm Infants in Later Life: The Role of Early Nutritional
Despina D Briana1, Ariadne Malamitsi-Puchner1
1Neonatal Intensive Care Unit, 3rd Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Chaidari, 12462 Athens, Greece.
Insights
Extremely preterm birth can lead to long-term respiratory issues. Early nutrition is key to promoting lung growth and repair in these vulnerable infants.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Developmental Biology
Background:
- Preterm birth (before 32 weeks gestation) poses significant risks for neonatal respiratory health.
- Improved neonatal care increases survival but can lead to long-term respiratory dysfunctions.
- Postnatal lung injuries from interventions like ventilation and oxygen therapy exacerbate risks.
Purpose of the Study:
- To review the long-term respiratory outcomes associated with extremely preterm birth.
- To discuss the role of early nutritional interventions in mitigating respiratory deficits.
- To update current understanding based on recent follow-up data.
Main Methods:
- Literature review of recent follow-up studies.
- Analysis of associations between preterm birth and respiratory sequelae.
- Evaluation of nutritional strategies for lung development and repair.
Main Results:
- Preterm birth disrupts normal respiratory tract development, increasing risks for chronic lung disease of prematurity (bronchopulmonary dysplasia) and other impaired lung functions.
- Long-term respiratory deficits can occur even without a BPD diagnosis.
- Early nutritional intake is a critical factor in promoting lung growth and repair in survivors.
Conclusions:
- Extremely preterm infants face lasting respiratory challenges.
- Nutritional interventions show promise in supporting lung development and improving long-term respiratory outcomes.
- Continued research and focus on early nutrition are vital for this population.
Abstract:
Birth occurring at ≤32 weeks' gestation ("very preterm") or at ≤28 weeks' gestation ("extremely preterm") potentially poses considerable health problems for the neonate, including respiratory sequelae, not only during the immediate newborn period, but throughout childhood and into adulthood. With the progressive improvements in neonatal care, the survival of extremely preterm and very preterm neonates has improved substantially. However, a considerable percentage of these infants suffer dysfunctions that may trigger, at some stage later in life, the onset of respiratory morbidities. The interruption of the normal development of the respiratory tract caused by preterm birth, in combination with postnatal lung injury caused by various interventions, e.g., mechanical ventilation and oxygen therapy, increases the risk ofthe development of long-term respiratory deficits in survivors. Those infants that are most affected are those who develop chronic lung disease of prematurity (also called bronchopulmonary dysplasia, BPD), but impaired lung function can develop irrespective of BPD diagnosis. Apart from indicating abnormal lung function in survivors of extreme prematurity, recent long-term follow-up studies also emphasize the crucial role of early nutritional intake as an effective strategy, which promotes lung growth and repair. This article will update the associations between extremely/very preterm birth with long-term respiratory outcomes. It will also discuss the protective effect of nutritional interventions, focusing on recently published follow-up data.
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