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Risk factors for hyperinflation in young schoolchildren born prematurely
F J Giffin1, A Greenough, G Dimitriou
1Department of Child Health, King's College Hospital, London, United Kingdom.
Insights
In premature children, lung hyperinflation at age 5 is linked to current symptoms, not early life factors. This elevated lung volume indicates ongoing respiratory issues.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Respiratory Physiology
Background:
- Premature birth is associated with lung function abnormalities, including hyperinflation.
- Hyperinflation, an elevated lung volume, is a common finding in these children.
- Understanding factors associated with hyperinflation is crucial for early intervention.
Purpose of the Study:
- To identify factors associated with lung hyperinflation in 5-year-old children born prematurely.
- To investigate the relationship between hyperinflation and current symptom status.
- To determine if perinatal variables predict hyperinflation in this cohort.
Main Methods:
- Functional residual capacity (FRC) was measured before and after bronchodilator therapy in 41 children born prematurely (median gestational age 30 weeks).
- Hyperinflation was defined as FRC > 120% of predicted value.
- Bronchodilator response was defined as a ≥10% change in FRC.
Main Results:
- Twelve percent (29%) of children exhibited hyperinflation at age 5.
- Hyperinflated children were significantly more likely to be symptomatic (58% vs 17%) and respond to bronchodilators (75% vs 14%).
- Regression analysis revealed that hyperinflation was significantly associated with current symptom status, but not with perinatal factors.
Conclusions:
- Hyperinflation in young children born prematurely is primarily linked to their current symptomatic status.
- Adverse neonatal events or perinatal factors do not appear to be significant predictors of hyperinflation at age 5.
- Findings suggest focusing on current respiratory symptoms for managing hyperinflation in this population.
Unlabelled:
Lung function abnormalities, including hyperinflation, are common in young children born prematurely. The aim of this study was, in such patients, to determine factors associated with hyperinflation, that is an elevated lung volume. Lung volume was estimated by measuring functional residual capacity (FRC) before and after bronchodilator therapy in 41 5-year-old children who had been born prematurely at a median of 30 weeks gestational age. Hyperinflation was defined as an FRC greater than 120% of that predicted for height and a positive bronchodilator response as a greater than or equal to 10% change in FRC. Twelve (29%) of the children were symptomatic at 5 years, their median FRC (132%) was significantly higher than that of the asymptomatic children (109%), P < 0.01). Twelve (29%) children were hyperinflated; a greater proportion of the hyperinflated compared to the non-hyperinflated patients were symptomatic at 5 years (7 or 58% versus 5 or 17%) (P < 0.05) and responded to bronchodilator therapy (9 or 75% versus 4 or 14%) (P < 0.01). Regression analysis demonstrated that hyperinflation related significantly only to current symptom status, but not perinatal variables.
Conclusion:
Hyperinflation in young children born prematurely reflects current symptom status and not adverse neonatal events.