Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist, Per; Tufvesson, Ellen; Bjermer, Leif; Winberg, Anna; Fellman, Vineta; Domellöf, Magnus; Melén, Erik; Norman, Mikael; Hallberg, Jenny

doi:10.1002/ppul.23919

Cited by 65 publications

(83 citation statements)

References 43 publications

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“…A majority of our participants had suffered from moderate to severe BPD in the neonatal period, some were born small for gestational age, and a significant proportion suffered from postnatal growth restriction. In the total EXPRESS cohort, asthma‐like disease was reported in 33% at follow‐up and among children born at 22‐24 weeks of gestation, 24% had FVC, and 44% had FEV 1 below the lower limit of normal . Nevertheless, all except one child investigated herein had normal pulmonary vascular resistance.…”

Section: Discussionmentioning

confidence: 74%

“…BPD is known to contribute to elevated pulmonary arterial vascular resistance in infancy, and if this should persist, it may induce long‐standing changes in the right ventricular geometry, structure, and function . We and others have reported significant reductions in lung function in children born extremely preterm and a high prevalence of asthma‐like symptoms compared with children born at term . Reduced lung function in childhood is considered to be an important driver for altered cardiovascular structure and function in adulthood …”

Section: Introductionmentioning

confidence: 87%

“…2,3 We and others have reported significant reductions in lung function in children born extremely preterm and a high prevalence of asthma-like symptoms compared with children born at term. 4,5 Reduced lung function in childhood is considered to be an important driver for altered cardiovascular structure and function in adulthood. 3,5 From a clinical perspective, it would be important to gain a better knowledge on whether childhood survivors of extreme prematurity suffering from reduced lung function should routinely be referred for an evaluation of the heart and pulmonary circulation.…”

Section: Introductionmentioning

confidence: 99%

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Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

et al. 2019

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Aim Children born preterm are at increased risk of reduced lung function. The aim was to test whether lung function was associated with pulmonary vascular resistance. Methods Participants were recruited from a population‐based cohort born in 2004‐2007. Lung function was assessed with spirometry after administration of a beta2‐agonist. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were determined. Estimations of pulmonary vascular resistance, arterial dimensions, right ventricular wall thickness, sphericity, and systolic (TAPSE) and diastolic functions were performed with echocardiography. Adjusted regression analyses were used to study associations. Results Sixty‐six children (33 boys) born at 22‐26 weeks of gestational age (birthweights 460‐1134 g) were assessed at a mean age of 6.7 years. Despite large variations in lung function with FVC z‐scores ranging from −4.6 to +2.8, there were no associations between lung function and pulmonary arterial pressure, right ventricular structure or function. Children with higher FVC z‐scores (r = .52, β = .55 mm, P = .015) and higher FEV1 z‐scores (r = .58, β = .73 mm, P = .001) exhibited larger pulmonary arteries. Conclusion In children born extremely preterm, lung function was not associated with pulmonary vascular resistance. Routine echocardiographic evaluation of extremely preterm children may not be indicated at age 6.5 years.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

et al. 2019

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“…The associations of neonatal respiratory measures with longitudinal respiratory health outcomes in preterm infants are presented in Table 3. Increasing evidence from large epidemiologic studies, such as EPICure, 31 EPIPAGE, 32 and EXPRESS, 33 confirmed that preterm birth has adverse effects on later lung function. The most consistent abnormality of pulmonary function for subjects born preterm was a reduction in % predicted FEV 1 , indicating airflow limitation related to obstructive ventilatory defects, regardless of whether these subjects had developed BPD or not.…”

Section: Prediction Of Longitudinal Respiratory Health Outcomesmentioning

confidence: 99%

Neonatal respiratory status predicts longitudinal respiratory health outcomes in preterm infants

Luo¹,

Wang

Chen

et al. 2019

Pediatric Pulmonology

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Objectives To examine the relationship between neonatal respiratory status and longitudinal respiratory health outcomes in preterm infants with very low birth weight (VLBW, birth weight <1500 g). Methods A total of 109 VLBW preterm infants were prospectively assessed for respiratory status using the Toce clinical and radiographic scoring method on a postnatal day 28, and severity of bronchopulmonary dysplasia (BPD) at 36‐weeks postmenstrual age (PMA), respiratory morbidity within 1 year of corrected age (CA), pulmonary function test, and six‐minute walk test at 4 years of age. Results A high Toce clinical score on day 28 was associated with the occurrence of respiratory morbidity within 1 year of CA and poor pulmonary function and functional exercise performance at 4 years of age in VLBW preterm infants (all P < 0.05). BPD at 36‐weeks PMA was associated with an increased risk of respiratory morbidity within 1 year of CA and its negative impact on pulmonary function and functional exercise performance at 4 years of age was most pronounced in the severe form (all P < 0.05). Conclusions Early assessments of neonatal respiratory status including Toce clinical score and the severity of BPD are valid to identify VLBW preterm infants who are at risk of adverse longitudinal respiratory health outcomes.

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“…Thunqvist and colleagues reported that pulmonary function testing using spirometry and oscillometry 6.5 years after pre-term birth at 22-26 weeks EGA showed increased bronchoreactivity to β-agonist treatment along with impaired FVC and FEV 1 . 20 The authors reported that nearly all their subjects were diagnosed with BPD, which likely affected the magnitude of impaired pulmonary function. As expected, the severity of BPD correlated with the severity of impairment.…”

Section: Demographics and Neonatal Lung Diseasementioning

confidence: 99%

2018 year in review: Part 2 of 4: Neonatal lung disease

Auten

2019

Pediatric Pulmonology

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Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Abstract: Background and objectives: Follow-up studies of children and young adults born very-

Cited by 65 publications

References 43 publications

Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

Neonatal respiratory status predicts longitudinal respiratory health outcomes in preterm infants

2018 year in review: Part 2 of 4: Neonatal lung disease

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