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Pulmonary function in children with initial low birth weight
M Wjst1, M Popescu, M J Trepka
1GSF-Forschungszentrum fuer Umwelt und Gesundheit, Institut fuer Epidemiologie, Neuherberg, Germany.
Insights
Low birth weight (LBW) in term-born children is linked to smaller lungs and hyperreactive airways, increasing asthma risk. Preterm children
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Respiratory Health
Background:
- Low birth weight (LBW) and prematurity are known risk factors for adverse health outcomes.
- The long-term respiratory effects of LBW and prematurity into school age require further investigation.
Purpose of the Study:
- To assess the impact of LBW and prematurity on school-aged children's bronchial airflow, reactivity, symptoms, and asthma diagnosis.
- To identify specific risk factors associated with these birth conditions and respiratory health outcomes.
Main Methods:
- A cross-sectional epidemiological study involving 2470 school children aged 5-14 in eastern Germany.
- Utilized a 78-item questionnaire for birth and early childhood risk factors.
- Conducted pulmonary function analysis using mobile plethysmography and cold air bronchial provocation tests.
Main Results:
- Term-born LBW children showed significantly increased bronchial hyper-responsiveness (p < 0.001) and a higher prevalence of diagnosed asthma (OR 1.6).
- LBW was associated with smaller lung volumes and reduced airflow, though effects were less pronounced in older children.
- Preterm children's bronchial systems appeared to recover by school age, with no increased risk for allergic sensitization in LBW children.
Conclusions:
- LBW is a significant risk factor for reduced lung function and hyperreactive airways in term-born children, contributing to asthma development.
- While LBW impacts lung development, preterm children may show respiratory recovery by school age.
- Findings highlight the importance of monitoring respiratory health in children with a history of LBW.
Abstract:
The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks; 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.