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Respiratory health in a total very low birthweight cohort and their classroom controls
1Public Health Research Unit, University of Glasgow.
Insights
Very low birthweight (VLBW) children show increased respiratory issues, including reduced lung capacity and higher rates of asthma. These long-term effects persist into childhood, impacting overall respiratory health.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Public Health
Background:
- Very low birthweight (VLBW) is associated with increased risks for adverse health outcomes.
- Respiratory health in VLBW survivors is a significant concern requiring long-term evaluation.
- Understanding the long-term respiratory impact of VLBW is crucial for targeted interventions.
Purpose of the Study:
- To compare the respiratory health and lung function of VLBW children with classroom controls at 8-9 years of age.
- To identify factors associated with impaired respiratory function in VLBW children.
- To investigate the relationship between VLBW, neonatal complications, and long-term respiratory outcomes.
Main Methods:
- A population-based cohort study design was employed.
- 300 VLBW children were compared with 590 age- and sex-matched classroom controls.
- Respiratory health, lung function (including FVC and FEV1/FVC ratio), and associated neonatal factors were assessed.
Main Results:
- VLBW children exhibited higher rates of inhaler use, school absenteeism, and respiratory hospital admissions.
- Reduced forced vital capacity (FVC) was observed in VLBW children, linked to prolonged ventilation and pneumothorax.
- Increased prevalence of obstructive airways disease and exercise-induced airway narrowing was noted in the VLBW group.
Conclusions:
- Respiratory morbidity is elevated in VLBW children, with FVC more affected than expiratory function.
- Poorer lung function in VLBW children is associated with very low birth weight itself, not intrauterine growth retardation.
- Findings underscore the need for ongoing respiratory monitoring in VLBW survivors.
Aims:
To compare the respiratory health and function at 8 to 9 years of age of a total population based cohort of 300 very low birthweight (VLBW) children with that of two classroom controls (n = 590) matched for age and sex.
Study Design:
Cohort study with controls.
Setting:
Schools throughout Scotland.
Results:
The VLBW children were more likely than their peers to use an inhaler, to be absent from school, and to be admitted to hospital because of respiratory illness. They were significantly shorter than their classroom controls, but even after adjusting for differences in height, the VLBW children had reduced forced vital capacity (FVC); this was associated with a history of prolonged ventilation (> 28 days) and pneumothorax in the neonatal period. There were no significant differences between the groups in forced expiratory volume in one second (FEV1)/FVC but twice as many (7.9% v 3.7%) of the VLBW children had ratios < 70%, denoting obstructive airways disease. Poor expiratory function was associated with neonatal respiratory distress syndrome, prolonged ventilation, and the need for > 40% oxygen. Exercise induced airway narrowing was increased in VLBW children (odds ratio = 2.0; 95% confidence interval 1.2 to 3.4) and was very little changed by adjustment for inhaler use and exposure to cigarette smoke.
Conclusions:
As in other low birthweight cohorts, respiratory morbidity was increased. Unlike previous studies, FVC was more affected than expiratory function in this VLBW population. Our findings support the hypothesis that poorer lung function is associated with very low birth weight, but not with intrauterine growth retardation.