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Pediatr Pulmonol. 2018 Jan;53(1):64-72. doi: 10.1002/ppul.23919. Epub 2017 Nov 20.

Lung function after extremely preterm birth-A population-based cohort study (EXPRESS).

Author information

1
Department of Pediatrics, Sachs' Children Youth Hospital Södersjukhuset, Stockholm, Sweden.
2
Department of Clinical Science and Education, Karolinska Institutet, Sodersjukhuset, Stockholm, Sweden.
3
Department of Clinical Sciences, Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
4
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
5
Department of Pediatrics, Clinical Sciences, Lund University, Lund, Sweden.
6
Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden.
7
Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
8
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
9
Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.

Abstract

BACKGROUND AND OBJECTIVES:

Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation).

METHODS:

In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed.

RESULTS:

Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L-1  · s-1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L-1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls.

CONCLUSION:

Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up.

KEYWORDS:

lung function tests; preterm birth; respiratory mechanics

PMID:
29152899
DOI:
10.1002/ppul.23919
[Indexed for MEDLINE]

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