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Impaired lung function and associated risk factors in children born prematurely: a systematic review and

Menne R van Boven1,2,3, Gerard J Hutten4,3, Rianne Richardson4,2

  • 1Emma Children's Hospital Amsterdam UMC, location University of Amsterdam, Department of Neonatology, Amsterdam, The Netherlands m.r.vanboven@amsterdamumc.nl.

European Respiratory Review : an Official Journal of the European Respiratory Society
|October 9, 2024
PubMed

Insights

Preterm children exhibit significantly impaired lung function, with lower forced expiratory volume in 1 second (FEV1). Risk factors include lower gestational age and bronchopulmonary dysplasia, confirming long-term pulmonary sequelae.

Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Respiratory Medicine

Background:

  • Preterm birth is associated with immature lung development and increased risk of long-term respiratory morbidity.
  • Quantifying lung function in preterm-born children is crucial for understanding and managing pulmonary sequelae.
  • Identifying risk factors for compromised lung function in this population is a key clinical challenge.

Approach:

  • Systematic review and meta-analysis of studies published since 1990 on preterm cohorts.
  • Included studies compared forced expiratory volume in 1 second (FEV1) in preterm children (≥5 years) to term-born controls.
  • Meta-regression analyses investigated demographic and neonatal variables impacting FEV1 effect sizes, with evidence certainty assessed by GRADE.

Key Points:

  • 42 studies comprising 4743 preterm and 9843 control children were analyzed.
  • Preterm children showed significantly lower FEV1 ( -0.58 sd; p<0.001) and a 2.9-fold increased risk of abnormal lung function.
  • FEV1 was significantly associated with gestational age, birthweight, bronchopulmonary dysplasia, and mechanical ventilation.

Conclusions:

  • Robust evidence demonstrates impaired lung function in preterm-born children.
  • High certainty of evidence supports these findings.
  • Gestational age and neonatal complications are significant predictors of reduced lung function.
Abstract

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