Pulmonary function in children with initial low birth weight

Abstract

The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks; 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.

Association of lung function with declining ambient air pollution.

“…Methods of pulmonary function measurements are described elsewhere (Frye et al 2001;Wjst et al 1998). Briefly, technicians were trained thoroughly at the beginning of each survey.…”

Spirometric Lung Function in School-Age Children

“…Rona and colleagues studied children aged 5-11 years and reported that lung function measurements, except forced midexpiratory flow between 25 and 75% of vital capacity (FEF 25-75% ), were positively associated with birthweight, but respiratory symptoms were associated with prematurity (10). Wjst and colleagues (11) reported decreased total lung capacity and peak expiratory flow rates, but increased bronchial reactivity and asthma in 5-14 year olds who were born with LBW.…”

Impact of Birth Weight and Smoking on Lung Function in Patients with Asthma, COPD, and Healthy Volunteers

“…Generally speaking, BW is one of several factors which may affect lung function and could predict future lung development. Usually this issue has been analyzed in children [6] in terms of very LBW, which is connected with many pre-and perinatal disturbances [2,3]. Our study was performed on a sufficiently large number of adult patients, and we attempted to demonstrate the influence of different BW quartiles on the most important spirometric parameters in this population.…”

“…The prevalence of asthma in males with BW < 2501 g was higher than in males with a BW between 3001-3500 g. Their other findings indicated that fetal growth retardation rather than preterm delivery of male infants was the main risk factor for developing asthma. Another study, performed by Wjst et al [6] on 2470 school children aged between 5-14 years, found that bronchial hyperresponsiveness was significantly increased in the examined group with LBW compared to normal term born children with correct BW (p < 0.001). Moreover, asthma was also more frequent in term born children with LBW.…”

“…There are a few studies that have shown dependence between BW and asthma [4][5][6]. Seidman et al [4] analyzed the impact of LBW on the occurrence of asthma symptoms in a large group of youth up to the age of 17 years old.…”