Childhood sequelae of infant lung disease: Exercise and pulmonary function abnormalities after bronchopulmonary dysplasia

Bader, David A.; Ramos, Alexander; Lew, Cheryl D.; Platzker, Arnold C. G.; Stabile, Michael W.; Keens, Thomas G.

doi:10.1016/s0022-3476(87)80004-5

Cited by 178 publications

(97 citation statements)

References 19 publications

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“…BPD survivors have more respiratory symptoms and reduced lung function from infancy [5] through to school age [6,7]. In the recently reported EPICure study, lung function was measured at 11 years in children born extremely preterm and abnormal baseline spirometry was found in almost half of the children tested, of whom 81% had prior BPD [8].…”

Section: Introductionmentioning

confidence: 99%

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

Gough

Linden

Spence

et al. 2013

European Respiratory Journal

156

126

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More infants with bronchopulmonary dysplasia (BPD) now survive to adulthood, but little is known regarding persisting respiratory impairment. We report respiratory symptoms, lung function and health-related quality of life (HRQoL) in adult BPD survivors compared with preterm (non-BPD) and fullterm controls.Respiratory symptoms (European Community Respiratory Health Survey) and HRQoL (EuroQol (EQ)-5D) were measured in 72 adult BPD survivors (mean¡SD study age 24.1¡4.0 years; mean¡SD gestational age 27.1¡2.1 weeks; and mean¡SD birth weight 955¡256 g) cared for in the regional neonatal intensive care unit, Royal Maternity Hospital, Belfast, UK (between 1978 and 1993). These were compared with 57 non-BPD controls (mean¡SD study age 25.3¡4.0 years; mean¡SD gestational age 31.0¡2.5 weeks; and mean¡SD birth weight 1238¡222 g) and 78 full-term controls (mean¡SD study age 25.7¡3.8 years; mean¡SD gestational age 39.7¡1.4 weeks; and mean¡SD birth weight 3514¡456 g) cared for at the same hospital. Spirometry was performed on 56 BPD, 40 non-BPD and 55 full-term participants.BPD subjects were twice as likely to report wheeze and three times more likely to use asthma medication than controls. BPD adults had significantly lower forced expiratory volume in 1 s and forced expiratory flow at 25-75% of forced vital capacity than both the preterm non-BPD and full-term controls (all p,0.01). Mean EQ-5D was 6 points lower in BPD adults compared to full-term controls (p,0.05).BPD survivors have significant respiratory and quality of life impairment persisting into adulthood.@ERSpublications Adult BPD survivors are more likely to have more respiratory symptoms, impaired health status and airflow obstruction than controls

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Section: Introductionmentioning

confidence: 99%

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

Gough

Linden

Spence

et al. 2013

European Respiratory Journal

156

126

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“…Although it is well established that prematurity is a major risk factor for the development of chronic lung disease, as a result of bronchopulmonary dysplasia, 1,2 and that extremely premature infants more frequently demonstrate persistent airway hyperresponsiveness in early childhood, 3 the influence of less extreme prematurity on the development of asthma among otherwise healthy children remains unresolved. Both low birth weight and prematurity were directly associated with the development of wheeze or asthma in several studies, [4][5][6][7] whereas other studies either failed to demonstrate an association [8][9][10][11] or demonstrated inverse relationships.…”

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confidence: 99%

Low-Normal Gestational Age as a Predictor of Asthma at 6 Years of Age

et al. 2004

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ABSTRACT. Background. Perinatal factors, including gestational age and birth weight, influence the development of atopy in early life. However, the role of these factors in the development of asthma in later life among children who do not develop perinatal respiratory disease remains unclear.Methods. Four hundred fifty-four infants who had a history of allergy or asthma in at least 1 parent, were born in the 36th week of gestation or later, and did not develop perinatal respiratory distress were monitored for at least 6 years. Associations between predictor variables and asthma and wheeze were assessed with multivariate logistic regression and repeated-event analyses.Results. Although we previously observed a relationship between low birth weight and persistent wheeze in the first 1 year of life, we did not observe similar associations between low birth weight and asthma at 6 years of age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 0.40 -2.73). However, a strong relationship was found between low-normal gestational age and asthma at 6 years of age (OR: 4.7; 95% CI: 2.1-10.5). The effects of low-normal gestational age were significantly greater among boys than among girls (boys: OR: 8.15; 95% CI: 2.98 -22.3; girls: OR: 1.90; 95% CI: 0.38 -13.83). Longitudinal analysis of the relationship between gestational age and wheeze during the 6 years of observation confirmed these gender differences.Conclusions. Among children at high risk of developing atopic disease, late prematurity might be an important additional determinant of asthma later in life, and these effects are gender specific. Pediatrics 2004; 114:e327-e332. URL: http://www.pediatrics.org/cgi/ content/full/114/3/e327; asthma, gestational age, birth weight, longitudinal studies.ABBREVIATIONS. IgE, immunoglobulin E; OR, odds ratio; CI, confidence interval. T here is substantial evidence that perinatal factors contribute to the development of both atopic disease and asthma. Although it is well established that prematurity is a major risk factor for the development of chronic lung disease, as a result of bronchopulmonary dysplasia, 1,2 and that extremely premature infants more frequently demonstrate persistent airway hyperresponsiveness in early childhood, 3 the influence of less extreme prematurity on the development of asthma among otherwise healthy children remains unresolved. Both low birth weight and prematurity were directly associated with the development of wheeze or asthma in several studies, 4-7 whereas other studies either failed to demonstrate an association [8][9][10][11] or demonstrated inverse relationships. 12 Although several of those studies were prospective, 6,8 most of the studies that demonstrated important effects included very premature infants (Ͻ36 weeks of gestation) in their analyses, making it difficult to separate the effects of prematurity from those associated with mechanical ventilation and respiratory distress syndrome. Moreover, few of those studies examined gender-differing effects, despite evidence of important gende...

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“…This scenario calls for continuing "surveillance processes" in the form of comprehensive follow-up studies that can provide valuable feedback to involved health care providers. BPD has in many studies been linked to lower FEV 1 , diffusing capacity and peak aerobic exercise capacity (Bader et al, 1987;Santuz et al, 1995;Jacob et al, 1997;Kriemler et al, 2005;Joshi et al, 2013) in childhood and adolescence. In our previous published study (Clemm et al, 2012), we did not find that BPD was related tȯ VO 2peak .…”

Section: Discussionmentioning

confidence: 99%

Ventilatory efficiency in children and adolescents born extremely preterm

Hestnes

Hoel

Røksund

et al. 2016

7.1 Paediatric Respiratory Physiology and Sleep

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Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals.Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46) and 1991-92 (n = 35) were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (V E ) and carbon dioxide output (VCO 2 ) was described by a linear model, and the relationship between tidal volume (V T ) andV E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term−born, sex, age, height, weight and forced expiratory volume in 1 s (FEV 1 ) as independent variables.Results: In adjusted analyses, the slope of theV E −VCO 2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV 1 only.Conclusion: EP-born participants breathed with higherV E for any given CO 2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term−born groups when adjusted for FEV 1 .

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Childhood sequelae of infant lung disease: Exercise and pulmonary function abnormalities after bronchopulmonary dysplasia

Cited by 178 publications

References 19 publications

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

Low-Normal Gestational Age as a Predictor of Asthma at 6 Years of Age

Ventilatory efficiency in children and adolescents born extremely preterm

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