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A comparison of respiratory function in Afro-Caribbean and Caucasian infants
J Stocks1, M Gappa, P S Rabbette
1Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, London, UK.
Insights
Lung function in newborns does not require separate reference values for white and black infants. This study found similar tidal breathing, Hering-Breuer reflex (HBR) activity, and total respiratory compliance (Crs) between ethnic groups.
Area of Science:
- Neonatal physiology
- Respiratory medicine
- Pediatric pulmonology
Background:
- Race influences lung function in older populations.
- Limited data exist on infant lung function across different ethnicities.
- Neonatal lung function tests require accurate normative values.
Purpose of the Study:
- Compare neonatal tidal breathing, Hering-Breuer reflex (HBR) activity, and total respiratory compliance (Crs).
- Assess if separate reference values are needed for Caucasian (white) and Afro-Caribbean (black) newborns.
- Investigate ethnic differences in respiratory parameters in healthy infants.
Main Methods:
- Measured respiratory function in 33 healthy black and 33 healthy white infants.
- Matched infants by sex, gestational age, weight, postnatal age, and maternal smoking.
- Analyzed minute ventilation, respiratory frequency, expiratory flow timing, HBR activity, and Crs.
Main Results:
- No significant differences found in minute ventilation, respiratory frequency, expiratory flow timing, or HBR activity between black and white infants.
- Total respiratory compliance (Crs) was similar in full-term black and white infants.
- Crs was slightly lower in preterm black infants compared to white infants, reaching statistical significance when related to body weight.
Conclusions:
- Separate reference values for tidal breathing, HBR activity, and Crs are not necessary for white and black babies in the immediate newborn period.
- Ethnic background does not necessitate distinct normative data for most measured respiratory parameters in neonates.
- Minor differences in Crs for preterm infants suggest potential, but not clinically significant, ethnic variations.
Abstract:
Race is recognized as an important determinant of lung function in children and adults, but limited data exist for infants. Accurate interpretation of lung function tests during the neonatal period may depend on appropriate values for predicting normality. The aim of this study was to compare tidal breathing parameters, Hering-Breuer reflex (HBR) activity, and total respiratory compliance (Crs) in healthy newborn caucasian (white) and Afro-Caribbean (black) infants, to determine whether separate reference values were required for these two ethnic groups. Respiratory function was measured in 33 healthy black infants, 18 of whom were premature, and 33 healthy white infants matched for sex, gestational age, weight, postnatal age, and maternal smoking during pregnancy. There were no significant paired differences between black and white infants with respect to minute ventilation, respiratory frequency, the ratio of time to reach peak expiratory flow to total expiratory time, or HBR activity. Values of Crs were similar in black and white full-term infants (37.5 (SD 9.0) versus 35.0 (6.3) ml.kPa-1, respectively) suggesting that, in the immediate newborn period, separate reference values are not necessary for these parameters. However, Crs was somewhat lower in black than white preterm infants (26.0(5.2) versus 29.5(7.2) ml.kPa-1, this difference reaching statistical significance if results were expressed in relation to body weight (95% confidence interval of within-pair differences -4.0 to -0.02 ml.kPa-1 x kg-1; p < 0.05). We conclude that no separate reference values for tidal breathing, Hering-Breuer reflex activity or total respiratory compliance are required for white and black babies in the immediate newborn period.(ABSTRACT TRUNCATED AT 250 WORDS)