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Mild prematurity and respiratory functions
T Todisco1, F M de Benedictis, L Iannacci
1Department of Pulmonology, University Hospital of Perugia, Italy.
Insights
Children born prematurely may have impaired lung function, even if they appear healthy. Maternal smoking during pregnancy is linked to these respiratory issues, increasing risks for adult chronic obstructive pulmonary disease (COPD).
Area of Science:
- Pediatrics
- Pulmonology
- Respiratory Medicine
Background:
- Premature birth can impact long-term respiratory health.
- Children born prematurely often undergo pulmonary function tests.
- Understanding lung development after prematurity is crucial for preventing adult respiratory disease.
Purpose of the Study:
- To compare pulmonary function and bronchial reactivity in prematurely born children and their siblings.
- To investigate the association between maternal smoking and respiratory function in premature infants.
- To identify potential risk factors for adult chronic obstructive pulmonary disease (COPD) in individuals with a history of prematurity.
Main Methods:
- Pulmonary function tests (PFTs) and methacholine challenge tests were performed.
- 34 prematurely born children and 34 siblings were assessed.
- Data on gestational age, birth weight, and maternal smoking were collected.
Main Results:
- Prematurely born children showed significantly increased residual volume (RV) and RV/total lung capacity (RV/TLC) compared to controls.
- Increased closing volume/vital capacity and closing capacity/total lung capacity (CC/TLC) were noted in most premature subjects with elevated RV.
- No significant difference in bronchial responsiveness to methacholine was found between groups.
- Maternal smoking during pregnancy correlated with impaired respiratory function in premature children.
Conclusions:
- Children born prematurely, even without neonatal respiratory distress, may exhibit subtle respiratory function impairments.
- Maternal smoking is a significant risk factor associated with these impairments.
- Early identification and protection from COPD risk factors are vital for prematurely born individuals, especially those with a history of maternal smoking.
Abstract:
Pulmonary function tests and bronchial reactivity to methacholine (MCH) were measured in 34 randomly selected prematures (21 males, 13 females; mean age 11.6 years; mean gestational age 34.9 weeks; mean birth weight 1980 g) and in 34 siblings (22 males, 12 females; mean age 12.5 years, mean gestational age 39.5 weeks; mean birth weight 3030 g). None had suffered neonatal respiratory distress syndrome or had been artificially ventilated. Prematurely born children had a residual volume (RV) and residual volume/total lung capacity (RV/TLC) significantly (P < 0.01) increased compared to controls, although the mean values of both groups were still within the upper limits of normal. Furthermore, an increase of closing volume/vital capacity and closing capacity/total lung capacity (CC/TLC) was observed in most patients with increased RV and RV/TLC. No significant difference was observed for bronchial responsiveness to MCH between prematurely born and control children (11.8% and 5.9% of hyperreactive subjects, respectively). Maternal smoking during pregnancy was prevalent in prematures with impaired respiratory functions. In conclusion clinically normal children of smoking mothers who have survived prematurity but present some respiratory function impairment compared to their born-at-term siblings, should be fully informed and protected from risk factors for chronic obstructive pulmonary disease (COPD) in adult life.