Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort study

Simpson, Shannon J.; Turkovic, Lidija; Wilson, Andrew; Verheggen, Maureen; Logie, Karla; Pillow, J. Jane; Hall, Graham L.

doi:10.1016/s2352-4642(18)30064-6

Cited by 137 publications

(124 citation statements)

References 45 publications

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“…Both preterm birth and tobacco exposure have previously been associated with persistently low lung function performance during childhood and adolescence 31 . In a recent cohort study, preterm children with or without BPD exhibited a persistent decline in lung function after 4 years of age 32 . However, the determinants of lung function evolution among preterm infants had not previously been investigated.…”

Section: Momentioning

confidence: 99%

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Lai

Chiang

Chu

et al. 2020

Sci Rep

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to investigate the evolution of lung function in preterm infants with and without bronchopulmonary dysplasia (BpD) and to determine the perinatal characteristics associated with indexes of lung function in later infancy. Longitudinal lung function assessments were performed at approximately 6, 12, 18, and 24 months of corrected age in preterm infants. Perinatal characteristics were further analyzed to ascertain the determinants of lung function indexes. Although all preterm infants (n = 121; 61 without BPD and 60 with BPD) exhibited decreased lung function in early infancy (6 months of age), after body length was adjusted for, only infants with BPD exhibited poor performance. Furthermore, the lung function of infants with mild to moderate BPD caught up gradually, but the generally poor lung function performance of infants with severe BPD, especially in forced expiratory flow, persisted until later age (24 months). Regarding perinatal characteristics, the z-score of body length at the time of examination and total number of days on positive-pressure ventilation are the major determinants of lung function in later infancy.Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in preterm infants, namely less than 37 weeks' gestational age, who were exposed to mechanical ventilation and oxygen supplementation. Dysplasia of microvessels, airways, and alveoli have been observed in lungs of such premature infants 1 . The "new" form of BPD, deemed a developmental disorder, differs pathologically and clinically from the "old" form 2 . Before the period of antenatal steroid and intratracheal surfactant, the "old" BPD occurred in preterm infants (usually late preterm) who suffered from surfactant deficiency. These infants required high-ratio oxygen and ventilatory support, which trigger a heterogenous lung injury and remodeling. The sequels of lung damage marks with regions of atelectasis and hyperinflation, hyperplasia of airway smooth muscle, lung fibrosis, and pulmonary vascular hypertensive changes 3 . After the period of prenatal steroid and postnatal surfactant intervention, the mortality of BPD significantly decreased, and shifted the demographics of BPD to more extreme preterm infants. "New" BPD then occurred and being characterized by arrested alveolar-capillary development, namely fewer and larger alveoli develop, reducing the overall surface available for gas exchange 4 . The airways are relatively less affected, and inflammation is usually less prominent than in the old form of BPD 1 .Although previous studies have showed that infants with BPD have significant decline in lung function till third decade of life 5 , it's uncertain whether this defect is a consequence of prematurity and/or BPD. Long-term studies on the lung function of survivors of old BPD have reported that abnormalities in forced expiratory flow persisted over time [6][7][8] . However, the results from these studies may differ from children with new BPD, which usually develops in more preterm infants, who might have received mar...

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Section: Momentioning

confidence: 99%

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Lai

Chiang

Chu

et al. 2020

Sci Rep

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“…A West Australian longitudinal study of preterm infants, 1997–2003, compared BPD and serial spirometry values from early childhood (4–8 years) to mid childhood (9–12 years). Preterm children with BPD had declines in spirometry z‐scores over time compared with term healthy controls in FEV 1 and FEV 1 /FVC of at least 0.1 z‐score per year …”

Section: Lung Function Outcomesmentioning

confidence: 97%

“…The airflow obstruction observed in early childhood has been shown to persist into mid‐childhood and adulthood therefore increasing the risk of chronic obstructive pulmonary disease (COPD) in adulthood.…”

Section: Lung Function Outcomesmentioning

confidence: 99%

Bronchopulmonary dysplasia: A review of the pulmonary sequelae in the post‐surfactant era

Haggie

Robinson

Selvadurai

et al. 2020

J Paediatrics Child Health

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We describe the respiratory complications of bronchopulmonary dysplasia (BPD) in childhood and adolescence. The pathophysiology of bronchopulmonary dysplasia has evolved in the era of modern neonatal intensive care. In this review, we aim to summarise the contemporary evidence base and describe the common respiratory morbidities related to BPD including; home oxygen therapy, rehospitalisation, asthma and exercise limitation.

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“…(1) Whilst it has been established that very preterm-born children born at <32 weeks' gestation have longer term lung function deficits,(2) especially if they develop bronchopulmonary dysplasia in infancy (also called chronic lung disease of prematurity,(3) it is increasingly recognised that even those born late preterm (33)(34)(35)(36) reported declines in lung function between the two time points compared to term controls. (7) Respiratory symptoms are also increased showing a gradient of increasing wheeze with increasing prematurity. (8,9) Even those born early term (37-38 weeks' gestation) have greater respiratory symptoms than children born at 39-40 weeks' gestation.…”

Section: Introductionmentioning

confidence: 99%

“…studied respiratory symptoms from early to mid-childhood and symptoms remained consistent. (7) However, thus far, no longitudinal studies have reported the wheezing phenotypes in preterm-born children. Wheezing-phenotype studies have included pretermborn children in their cohorts but have not specifically examined them.…”

Section: Introductionmentioning

confidence: 99%

Association of early life factors with wheezing phenotypes in preterm-born children compared to term-born children

Kotecha

Watkins

Lowe

et al. 2018

Paediatric Respiratory Epidemiology

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Although respiratory symptoms, including wheezing, are common in preterm-born subjects, the natural history of the wheezing-phenotypes and the influence of early life factors and characteristics on phenotypes are unclear. Participants from the Millennium Cohort Study born between 2000-2002 were studied at 9 months, 3, 5, 7, and 11 years. We used datadriven methods to define wheezing-phenotypes in preterm-born children and investigated if the association of early life factors and characteristics on wheezing-phenotypes were similar between preterm-and term-born children. 1,049/1502 (70%) preterm-born children, and 12,307/17,063 (72%) term-born had recent wheeze data for three or four time-points.Recent-wheeze was greater at all time-points in preterm-born than term-born group. Four wheezing-phenotypes were defined: no/infrequent, early, persistent and late for both groups. Early life factors and characteristics, especially antenatal smoking, atopy, male gender, were associated with increased rates for all phenotypes in both groups breast feeding was protective in both groups, except late-wheeze in the preterm group. Pretermborn children had similar phenotypes to term-born children. Although early life factors and characteristics were similarly associated with the wheezing-phenotypes in both groups, the preterm group had higher rates of early and persistent-wheeze. However, a large proportion of preterm-born children had early-wheeze which resolved with time.

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Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort study

Cited by 137 publications

References 45 publications

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Bronchopulmonary dysplasia: A review of the pulmonary sequelae in the post‐surfactant era

Association of early life factors with wheezing phenotypes in preterm-born children compared to term-born children

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