Characteristics of asthma and airway hyper‐responsiveness after premature birth

Halvorsen, Thomas; Skadberg, Britt T.; Eide, Geir Egil; Røksund, Ola Drange; Aksnes, Lage; Øymar, Knut

doi:10.1111/j.1399-3038.2005.00314.x

Cited by 108 publications

(95 citation statements)

References 36 publications

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“…The fact that the airways obstruction observed in these children was only partially reversible raises the issue as to whether these children have been correctly diagnosed, or optimally treated [11]. Consistent with previous reports [9,10], airway responsiveness was increased among the EP children, although had we not undertaken identical challenges in prospective controls the extent of such hyperresponsiveness would have been overestimated (refer to supplementary data). Children with BPD are known to be at increased risk for symptomatic respiratory illnesses in infancy and childhood.…”

Section: Respiratory Morbiditysupporting

confidence: 71%

“…Although a wide range of tests have been used to assess cardio-respiratory function in survivors of pre-term birth [2,5,6,9,10], relatively few studies have included the full spectrum of available techniques and spirometric parameters remain the most common outcomes, as used during recent school assessments of survivors of the EPICure cohort at 11 yrs of age [11]. In that study, 56% of children born before 25w +6 gestation were found to have abnormal baseline spirometry, 27% had a positive bronchodilator response and 25% a diagnosis of asthma (twice that observed in classmates).…”

mentioning

confidence: 99%

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Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

Lum¹,

Kirkby²,

Welsh³

et al. 2010

European Respiratory Journal

154

140

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Advances in neonatal care have resulted in increased survival of children born extremely pre-term (EP). Nevertheless the incidence of bronchopulmonary dysplasia and longterm respiratory morbidity remains high. We investigated the nature of pathophysiological changes at 11 yrs of age to ascertain whether respiratory morbidity in EP children primarily reflects alterations in the lung periphery or more centralised airway function in this population.Spirometry, plethysmography, diffusing capacity, exhaled nitric oxide, multiple-breath washout, skin tests and methacholine challenge were used during laboratory-based assessments in a subgroup of the 1995 EPICure cohort and in controls.Results were obtained in 49 EP and 52 control children. Lung function abnormalities were found in 78% of EP children, with evidence of airway obstruction, ventilation inhomogeneity, gas trapping and airway hyperresponsiveness. Levels of atopy and exhaled nitric oxide were similar between the groups. Prior wheeze was associated with significant reductions in forced flows and volumes. By contrast, abnormalities of the lung periphery appear to be mediated primarily through EP birth per se.The prevalence of lung function abnormalities, which is largely obstructive in nature and likely to have long-term implications, remains high among 11-yr-old children born EP. Spirometry proved an effective means of detecting these persistent abnormalities.

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Section: Respiratory Morbiditysupporting

confidence: 71%

mentioning

confidence: 99%

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

Lum¹,

Kirkby²,

Welsh³

et al. 2010

European Respiratory Journal

154

140

View full text Add to dashboard Cite

show abstract

“…]. However, these interactions are less evident among preterm-born children who show low levels of exhaled nitric oxide and little evidence of eosinophilic inflammation compared to term-born asthmatic children [114,115]. The occurrence of atopy and allergic sensitization is less frequent following preterm birth, which might be related to altered immune programming during early life and the shift toward a more tolerant immunophenotype [18].…”

Section: Viral Infection Requiring Readmission In Early Lifementioning

confidence: 99%

The impact of respiratory viruses on lung health after preterm birth

Townsi

Laing

Hall

et al. 2018

European Clinical Respiratory Journal

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Children born preterm, less than 37 weeks’ gestation, are at increased risk of viral respiratory infections and associated complications both during their initial birth hospitalisation and in their first years following discharge. This increased burden of viral respiratory infections is likely to have long term implications for lung health and function in individuals born preterm, particularly those with bronchopulmonary dysplasia. Several hypotheses have been put forward to explain the association between early life viral respiratory infection and development of suboptimal lung health and function later in life following preterm birth. Although preterm infants with diminished lung function, particularly small airways, might be particularly susceptible to asthma and wheezing disorders following viral infection, there is evidence that respiratory viruses can activate number of inflammatory and airway re-modelling pathways. Therefore, the aim of this review is to highlight the perinatal and early life risk factors that may contribute to increased susceptibility to viral respiratory infections among preterm infants during early life and to understand how respiratory viral infection may influence the development of abnormal lung health and function later in life.

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“…5 Much of the existing evidence focuses on adults with a history of BPD, who do have more pulmonary symptoms and respiratory function abnormalities (including obstructed airflow) than those born at term. 2,[6][7][8][9][10][11][12] Whether this outcome applies to adults born preterm at VLBW who have no history of BPD is less conclusive. Most studies may not include a sufficient number of subjects to distinguish between those with a history of BPD and those without.…”

Section: What This Study Addsmentioning

confidence: 99%

Lung Function in Very Low Birth Weight Adults

et al. 2015

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BACKGROUND AND OBJECTIVES: Lung function attained in young adulthood is 1 of the strongest predictors of obstructive airways disease in later life. Adults born preterm at very low birth weight (VLBW; ,1500 g) who have experienced bronchopulmonary dysplasia (BPD) have reduced lung function. We studied the association of lung function in young adulthood with preterm birth at VLBW and with BPD and other prenatal and neonatal conditions. METHODS:We performed spirometry for 160 VLBW subjects (29 with BPD according to Northway criteria) aged 18 to 27 years and 162 term control subjects group-matched for gender, age, and birth hospital. Lung function was expressed as z scores according to the Global Lung Function Initiative standards.RESULTS: Forced expiratory volume in 1 second z score was 1.41 units (95% confidence interval [CI]: 0.89 to 1.94) lower in BPD-VLBW subjects and 0.39 units (95% CI: 0.08 to 0.69) in non-BPD VLBW subjects compared with control subjects. Corresponding differences for forced expiratory volume in 1 second/forced vital capacity were 1.52 (95% CI: 0.99 to 2.05) and 0.51 (95% CI: 0.21 to 0.81), respectively. Maternal smoking in pregnancy predicted poorer airflow in all groups; this finding was strongest in the BPD-VLBW group. Lung function was unrelated to fetal or postnatal growth or to neonatal respiratory distress syndrome.

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Characteristics of asthma and airway hyper‐responsiveness after premature birth

Cited by 108 publications

References 36 publications

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

The impact of respiratory viruses on lung health after preterm birth

Lung Function in Very Low Birth Weight Adults

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