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Bronchopulmonary dysplasia and very low birthweight: lung function at 11 years of age
L W Doyle1, G W Ford, A Olinsky
1Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
Insights
Children born with bronchopulmonary dysplasia (BPD) show reduced lung function at age 11. However, most very low birthweight (VLBW) survivors with BPD do not have clinically significant lung function deficits.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Respiratory Physiology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Very low birthweight (VLBW) survivors are at risk for long-term respiratory complications.
- Understanding the long-term lung function in VLBW children is crucial for their health outcomes.
Purpose of the Study:
- To investigate the relationship between neonatal bronchopulmonary dysplasia (BPD) and lung function at 11 years of age in very low birthweight (VLBW) children.
- To compare lung function trajectories in VLBW children with and without a history of BPD.
- To identify the prevalence of clinically significant lung function abnormalities in VLBW survivors with BPD.
Main Methods:
- A cohort of 154 surviving very low birthweight (VLBW) children was divided into three groups based on neonatal respiratory morbidity: BPD, assisted ventilation without BPD, and no assisted ventilation.
- Lung function tests were performed at 11 years of age on 120 children.
- Multiple linear regression analysis was used to examine the association between neonatal lung disease and lung function variables.
Main Results:
- VLBW children with a history of BPD exhibited significantly diminished airflow variables and higher residual volumes at 11 years compared to those without BPD.
- Despite overall poorer lung function, only a small proportion (13.3%) of the BPD group had clinically significant lung function abnormalities.
- No significant differences in lung function were observed between VLBW children who required assisted ventilation but did not develop BPD and those who required no assisted ventilation.
Conclusions:
- Neonatal bronchopulmonary dysplasia (BPD) is associated with poorer lung function at 11 years of age in very low birthweight (VLBW) survivors.
- While lung function is generally reduced in VLBW children with a history of BPD, clinically significant deficits are uncommon.
- Lung function outcomes at 11 years appear stable between 8 and 11 years across the studied groups.
Objective:
To determine the relationship between lung function at 11 years of age and bronchopulmonary dysplasia (BPD) in very low birthweight (VLBW) children.
Methodology:
This study comprised 154 consecutive surviving VLBW children, divided into three groups with respect to their neonatal respiratory morbidity: group I developed BPD; group II required assisted ventilation but did not develop BPD; and group III required no assisted ventilation. Lung function tests were measured on 120/154 (77.9%) children at 11 years of age. The relationship between various lung function variables and neonatal lung disease was analysed by multiple linear regression.
Results:
Several lung function variables reflecting airflow were significantly diminished in the BPD group (n = 15), and residual volume was significantly higher. Despite poorer lung function overall, few children in the BPD group had lung function abnormalities in the clinically significant range (n = 2[13.3%] with a forced expired volume in 1 $ < 75% predicted; n = 2[13.3%] with a forced vital capacity < 75% predicted; n = 1 [6.7%] with a residual volume/total lung capacity > 35%). There were no significant differences in lung function variables between group II (n = 41) and group III (n = 64). Changes in lung function tests between 8 and 11 years did not very significantly between the three groups.
Conclusions:
VLBW children with BPD in the newborn period have period have poorer lung function at 11 years of age than other surviving VLBW children without BPD, although few have lung function abnormalities in the clinically significant range.