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Respiratory morbidity in young school children born prematurely--chronic lung disease is not a risk factor?
A Greenough1, F J Giffin, B Yüksel
1Department of Child Health, King's College Hospital, London, UK.
Insights
A family history of atopy, not severe chronic lung disease (CLD), was linked to respiratory symptoms in children born prematurely. High airway resistance at age one also predicted later symptoms.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Neonatology
Background:
- Premature birth is associated with increased risk of respiratory issues.
- Chronic lung disease (CLD) is a significant concern in preterm infants.
- Understanding long-term respiratory outcomes is crucial for managing premature children.
Purpose of the Study:
- To identify etiological associations of respiratory symptoms in children born prematurely at 5 years of age.
- To assess the specific impact of severe chronic lung disease (CLD) on respiratory health.
- To explore the relationship between early lung function and later respiratory status.
Main Methods:
- Prospective follow-up study of 103 children born prematurely (median gestational age 29 weeks).
- Assessment of respiratory status at 5 years via parental history.
- Analysis of severe CLD (oxygen dependence >36 weeks postconceptional age) and lung function at 1 year.
- Regression analysis to determine significant associations with respiratory symptoms.
Main Results:
- A family history of atopy was the only significant predictor of respiratory symptoms at 5 years.
- Severe CLD and other perinatal variables did not significantly relate to symptom status.
- High airway resistance at 1 year of age was significantly associated with positive symptom status at 5 years.
Conclusions:
- Reducing severe chronic lung disease may have a limited impact on respiratory morbidity in school-aged children born prematurely.
- Family history of atopy and early airway resistance are key factors in predicting respiratory symptoms in this population.
Unlabelled:
Children born prematurely and recruited into a prospective follow up study were examined at 5 years of age. Our aim was to determine aetiological associations of respiratory symptoms in such children and, in particular, to determine the importance of severe chronic lung disease (CLD, oxygen dependence beyond 36 weeks post conceptional age). Respiratory status was documented from parental history in 103 children of median gestational age 29 weeks (range 23-35), 17 of whom had suffered from severe CLD. In 90 of the 103 children lung function had been assessed at 1 year of age. Regression analysis revealed that neither severe CLD nor other perinatal variables, but only a family history of atopy, significantly related to a positive symptom status. A high airways resistance at 1 year also significantly related to positive symptom status.
Conclusion:
Reduction in severe CLD (oxygen dependence beyond 36 weeks postconceptional age) may make relatively little impact on respiratory morbidity in young school children born prematurely.