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Lung function outcomes in adults born extremely preterm across three decades of advancing perinatal medicine

Tonje Bårdsen1,2, Emma Satrell3, Ola Drange Røksund1,4

  • 1Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.

Acta Paediatrica (Oslo, Norway : 1992)
|November 22, 2024
PubMed

Insights

Adults born extremely preterm (EP) had stable lung function overall across three decades. However, lung function improved in EP subgroups with bronchopulmonary dysplasia (BPD) over time.

Area of Science:

  • Neonatal medicine
  • Pulmonology
  • Perinatal outcomes

Background:

  • Neonatal care advances from 1980-2000 improved survival for extremely preterm (EP) infants.
  • Long-term lung function in adults born EP remains incompletely understood.
  • Investigating cohort effects on adult lung function is crucial.

Purpose of the Study:

  • To examine long-term lung function in adults born extremely preterm.
  • To identify potential cohort effects in adult lung function based on neonatal care advancements.
  • To assess differences in lung function between EP-born individuals and term-born controls.

Main Methods:

  • Population-based study of three 18-year-old cohorts born extremely preterm (EP) or as term-controls.
  • EP cohorts born 1982-85, 1991-92, and 1999-2000 (gestation ≤28 weeks or birthweight ≤1000g).
  • Pulmonary function tests including spirometry, plethysmography, diffusing capacity, and airway responsiveness were performed.

Main Results:

  • Adults born EP exhibited reduced FEV1, FEV1/FVC, FEF25-75%, DLCO, and KCO compared to term-controls across all cohorts.
  • Deficits in z-scores for FEV1 and DLCO were observed, with some reduction in magnitude across cohorts.
  • Significant improvements in z-FEV1, z-FEV1/FVC, and z-FEF25-75% were noted in EP subgroups with bronchopulmonary dysplasia (BPD) across cohorts.

Conclusions:

  • Adults born extremely preterm (EP) demonstrate stable overall lung function across three decades of evolving neonatal care.
  • Notable improvements in lung function were observed in EP subgroups with a history of bronchopulmonary dysplasia (BPD) over successive cohorts.
  • These findings highlight the impact of neonatal care on long-term respiratory health in EP survivors.
Abstract

Keywords:
BPDadultcohort studyextremely prematurerespiratory outcome

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