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Updated: Jun 30, 2025

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Expiratory airflow limitation in adults born extremely preterm: A systematic review and meta-analysis

Henriette Lahn-Johannessen Lillebøe1, Merete Salveson Engeset2, Hege H Clemm3

  • 1Department of Clinical Science, University of Bergen, Bergen, Norway.

Paediatric Respiratory Reviews
|March 15, 2024
PubMed

Insights

Adults born extremely preterm (<28 weeks) show significant airflow limitation, with lung function more impaired in those with neonatal bronchopulmonary dysplasia. These findings highlight lifelong respiratory health risks for extremely preterm infants.

Area of Science:

  • Pulmonary Medicine
  • Neonatology
  • Adult Respiratory Health

Background:

  • Extreme preterm (EP) birth before 28 weeks gestation disrupts fetal development, leading to early pulmonary trauma and lifelong respiratory risks.
  • Investigating long-term lung function in EP-born adults is crucial for understanding and managing chronic respiratory conditions.

Approach:

  • A systematic review and meta-analysis synthesized data from 16 studies involving 1036 EP-born adults.
  • Lung function parameters including FEV1, FVC, and FEV1/FVC were compared to reference values, with subgroup analyses based on surfactant use and BPD status.

Key Points:

  • EP-born adults exhibit reduced FEV1 (85.30% predicted) and FEV1/FVC (79.54%), indicating significant airflow limitation.
  • Lung function was not significantly different before or after widespread surfactant use but was more impaired in those with neonatal bronchopulmonary dysplasia (BPD).
  • While most EP-born adults do not meet COPD criteria at a group level, the observed impairments are concerning for long-term respiratory health.

Conclusions:

  • Extreme preterm birth is associated with persistent airflow limitation in adulthood.
  • Neonatal BPD is a significant factor contributing to impaired lung function in EP-born adults.
  • These findings underscore the need for ongoing respiratory monitoring and care for individuals born extremely preterm.

Keywords:
AdultExtremely low birth weightExtremely prematureFEV(1)Lung functionRespiratory function

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