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Effect of preterm birth on pulmonary function at school age: a prospective controlled study
S J Gross1, D M Iannuzzi, D A Kveselis
1Department of Pediatrics, State University of New York, Health Science Center, Syracuse 13210, USA.
Insights
Children born prematurely with bronchopulmonary dysplasia (BPD) experience long-term lung problems, including airway obstruction and increased rehospitalization. Those born preterm without BPD had similar lung function to term-born children at age 7.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Long-term pulmonary outcomes for preterm survivors require further investigation.
- Understanding the impact of BPD on childhood lung health is crucial for clinical management.
Purpose of the Study:
- To evaluate the long-term pulmonary function in a cohort of children born preterm (< 32 weeks' gestation).
- To compare pulmonary outcomes between preterm children with and without a history of BPD.
- To compare outcomes with a matched group of children born at term.
Main Methods:
- A regional cohort of 125 surviving preterm children (24-31 weeks' gestation) was assessed at age 7.
- A sociodemographically matched term-born control group was included for comparison.
- Pulmonary function tests, including spirometry and bronchodilator responsiveness, were performed.
Main Results:
- Preterm children with prior BPD had higher rehospitalization rates (53% vs. 26%) in the first two years.
- At age 7, the BPD group exhibited significantly more airway obstruction (reduced FVC, FEV1, FEF25-75%) compared to both preterm without BPD and term controls.
- Bronchodilator responsiveness was more frequent in preterm children with BPD (47%) than in those without (25%) or term controls (21%).
Conclusions:
- Preterm children without a history of BPD exhibit normal pulmonary function at school age, comparable to term-born peers.
- Preterm children with a history of BPD demonstrate persistent abnormal pulmonary function and airway obstruction.
- History of BPD is a significant predictor of long-term respiratory morbidity in preterm survivors.
Objective:
To assess long-term pulmonary outcome of a regional cohort of children born at < 32 weeks' gestation compared with a matched term control group.
Study Design:
All 125 surviving children born at 24 to 31 weeks' gestation during a 1-year period and a sociodemographically matched term control group were evaluated at age 7 years.
Results:
Preterm children with previous bronchopulmonary dysplasia (BPD) were twice as likely to require rehospitalization during the first 2 years of life than were preterm children without BPD (53% vs 26%, P < .01). At 7 years of age the BPD group had more airway obstruction than did both preterm children without BPD and the term control group (significantly reduced mean forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow, 25% to 75% vital capacity, all, P < .001). Lung function among preterm children without previous BPD was similar to that of the term control group. Bronchodilator responsiveness was observed twice as often in preterm children with previous BPD (20 of 43, 47%) compared with preterm children without BPD (13 of 53, 25%) or the term control group (23 of 108, 21%, P < .001). These differences remained significant after adjustment was done for birth weight and gestational age.
Conclusion:
Preterm children without BPD demonstrate pulmonary function at school age similar to that of children in a healthy term control group, whereas preterm children with previous BPD demonstrate abnormal pulmonary function.