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Published on: April 29, 2013
Cardiopulmonary Exercise Performance of Children Born Non-Extremely Preterm
Sotirios Fouzas1, Aikaterini Nourloglou1, Aggeliki Vervenioti1
1Department of Pediatrics, University of Patras School of Medicine, 26504 Patras, Greece.
Insights
Children born non-extremely preterm, especially before 34 weeks gestation, show reduced exercise performance. This is linked to altered breathing patterns and impaired oxygen use during exercise, not heart or lung limitations.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Neonatal Medicine
Background:
- Limited data exists on the exercise tolerance of children born non-extremely preterm.
- Understanding cardiopulmonary exercise testing (CPET) characteristics is crucial for this population.
Purpose of the Study:
- To explore CPET characteristics in school-aged children born non-extremely preterm.
- To compare exercise performance between preterm-born and term-born children.
Main Methods:
- Sixty-three preterm-born children (29-36 weeks gestation) and 63 term-born controls (ages 7-12) underwent spirometry and cycle ergometry CPET.
- Peak oxygen uptake (VO2peak), ventilatory, and cardiovascular limitations were assessed.
Main Results:
- Preterm-born children had significantly lower VO2peak (<80% predicted) compared to term-born controls (49.2% vs 25.4%).
- Children born before 34 weeks gestation exhibited lower VO2peak than late preterm and term-born children.
- Altered ventilatory responses (higher respiratory rate, lower tidal volume) and impaired oxygen utilization were observed in those born before 34 weeks.
Conclusions:
- School-aged children born between 29-34 weeks gestation may have decreased exercise performance.
- This reduction is likely due to altered ventilatory responses and impaired skeletal muscle oxygen utilization.
- Cardiopulmonary limitations other than ventilatory or cardiovascular factors appear less significant.
Abstract:
Data on exercise tolerance of children born non-extremely preterm are sparse. We aimed to explore the cardiopulmonary exercise testing (CPET) characteristics in this population. We studied 63 children (age 7-12 years) born at 290/7-366/7 weeks of gestation (34 were late preterm, 29 were preterm) and 63 age-matched, term-born controls. All performed spirometry and CPET (cycle ergometry). There were no differences in activity levels and spirometric parameters between the group of preterm-born children and controls. A peak oxygen uptake (VO2peak) of <80% was noted in 25.4% of the term-born and 49.2% of preterm-born children (p = 0.001). Term-born participants presented similar VO2peak to late-preterm children but higher than those born at <340/7 weeks of gestation (p = 0.002). Ventilatory limitation was noted in 4.8% of term and 7.9% of preterm participants, while only one preterm child presented cardiovascular limitation. Children born before 34 weeks of gestation had higher respiratory rates and smaller tidal volumes at maximum exercise, as well as lower oxygen uptake for the level of generated work. We conclude that school-age children born at 29-34 weeks of gestation may present decreased exercise performance attributed to an altered ventilatory response to exercise and impaired O2 utilization by their skeletal muscles rather than other cardiopulmonary limiting factors.
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