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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs

Published on: October 31, 2025

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Determinants of declining lung function trajectories from childhood to adulthood after preterm birth

James T D Gibbons1,2,3, Elizabeth F Smith1,2, Andrew C Wilson1,3

  • 1Foundations of Lung Disease, Wal-yan Respiratory Research Centre, The Kids Research Institute Australia, Perth, Western Australia, Australia.

Thorax
|April 20, 2026
PubMed

Insights

Very preterm birth survivors show declining lung function, increasing risk for chronic obstructive pulmonary disease. Early screening and interventions can mitigate this progressive airway obstruction.

Area of Science:

  • Pulmonary Medicine
  • Pediatric Pulmonology
  • Respiratory Health

Background:

  • Preterm birth (PTB) is linked to long-term respiratory issues, but lung function development in survivors is not fully understood.
  • Lifelong respiratory sequelae in PTB survivors necessitate research into lung function trajectories.

Purpose of the Study:

  • To identify distinct patterns of spirometry development from childhood to early adulthood in very preterm birth survivors.
  • To analyze risk factors associated with declining lung function trajectories in this population.

Main Methods:

  • Longitudinal study of 116 very preterm (≤32 weeks' gestation) and 39 term-born individuals.
  • Spirometry performed up to four times between ages 4-23 years.
  • Group-based trajectory modeling used to derive FEV1, FVC, and FEV1/FVC z-score patterns; regression analysis assessed risk factors.

Main Results:

  • Preterm survivors exhibited distinct trajectories, including low-declining FEV1 and very-low-declining FEV1/FVC.
  • Term controls maintained stable lung function.
  • Higher gestational age and early childhood FEV1 were protective against FEV1 decline; asthma and CT abnormalities increased risk. Asthma, CT abnormalities, and bronchodilator responsiveness increased risk for FEV1/FVC decline.

Conclusions:

  • A significant proportion of very preterm survivors experience progressive airway obstruction from childhood to young adulthood.
  • Preterm birth is a key risk factor for early-onset chronic obstructive pulmonary disease (COPD).
  • Early lung function screening and targeted interventions for modifiable risk factors are crucial for preventing severe airway obstruction.
Abstract

Keywords:
Bronchopulmonary DysplasiaCOPD PathologyPaediatric Lung DiseasePulmonary Disease, Chronic Obstructive

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