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Lung function in adults born with very low birth weight from young to mid-adulthood
Laura Jussinniemi1,2, Silje D Benum3, Kristina A D Aakvik3
1Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. laura.jussinniemi@oulu.fi.
Insights
Adults born preterm with very low birth weight (VLBW) experience persistent reduced lung function, especially those with a history of bronchopulmonary dysplasia (BPD), which worsens with age. Respiratory symptoms in VLBW adults warrant careful medical evaluation.
Area of Science:
- Pulmonary Medicine
- Neonatology
- Adult Health
Background:
- Individuals born preterm with very low birth weight (VLBW; <1500g) often exhibit diminished lung function compared to term-born peers.
- Neonatal bronchopulmonary dysplasia (BPD) is associated with more severe lung function impairments in VLBW individuals.
Purpose of the Study:
- To investigate whether lung function impairments in VLBW adults worsen between young and mid-adulthood.
- To compare the progression of lung function in VLBW adults with and without a history of BPD against term-born controls.
Main Methods:
- Two birth cohorts (HeSVA and NTNU LBW Life) with harmonized protocols were studied.
- Spirometry assessed lung function in 115 VLBW (20 with BPD) and 142 control adults at mean age 36 years.
- Results were compared to spirometry data from young adulthood (mean age 22 years) in 198 VLBW (32 with BPD) and 225 control participants.
Main Results:
- In mid-adulthood, BPD-VLBW adults showed significantly lower z-scores for forced expiratory volume in 1s (zFEV1) and FEV1/forced vital capacity (FVC) compared to controls.
- Non-BPD-VLBW adults also had reduced zFEV1 and FEV1/FVC, though the differences were less pronounced than in the BPD-VLBW group.
- The decline in zFVC and zFEV1 from young to mid-adulthood was greater in the BPD-VLBW group compared to controls.
Conclusions:
- Adults born preterm with VLBW experience reduced airflow in mid-adulthood compared to term-born individuals.
- Individuals with a history of BPD exhibit more pronounced airflow limitations and potentially faster vital capacity decline.
- Clinicians should consider birth history, including VLBW and BPD, in adults presenting with respiratory symptoms, as lung function impairments do not improve and may worsen with age.
Background:
Young adults born preterm with very low birth weight (VLBW; <1500 g), especially those who had neonatal bronchopulmonary dysplasia (BPD), have reduced lung function compared with their term-born peers. We hypothesized that these impairments worsen between young and mid-adulthood.
Methods:
We studied two birth cohorts: HeSVA (Finland) and NTNU LBW Life (Norway) with harmonized protocols. Lung function was assessed by spirometry in 115 VLBW (20 with BPD) and 142 controls at mean 36 years. The results were compared with young adulthood (22 years) spirometry in 198 VLBW (32 with BPD) and 225 control participants.
Results:
In mid-adulthood, BPD-VLBW adults had lower z-scores in forced expiratory volume in 1 s (zFEV1; mean difference -1.49; 95%CI -1.94, -1.04) and in zFEV1/FVC (FVC: forced vital capacity; mean difference -0.84, 95%CI -1.23, -0.44) than controls. Corresponding differences for non-BPD-VLBW adults were -0.34 (95%CI -0.60, -0.08) and -0.30 (95%CI -0.53, -0.07). The differences in zFVC and zFEV1 between BPD-VLBW and control groups increased from young to mid-adulthood.
Conclusion:
In mid-adulthood, adults born preterm with VLBW had reduced airflow compared with term-born controls. These differences were more pronounced among those with a history of BPD, whose vital capacity also seems to decline faster.
Impact:
Impaired airflow and reduced vital capacity in VLBW adults do not improve with age. Among those with a history of BPD, vital capacity seems to reduce faster than among their term-born peers. Clinicians who see adults born preterm with VLBW should be vigilant for respiratory symptoms. We argue that a full medical history in all adults who present with respiratory symptoms should routinely include key birth characteristics such as preterm birth.
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