Respiratory illness contributed significantly to morbidity in children born extremely premature or with extremely low birthweights in 1999–2000

Skromme, Kaia; Leversen, Katrine Tyborg; Eide, Geir Egil; Markestad, Trond; Halvorsen, Thomas

doi:10.1111/apa.13165

Cited by 23 publications

(17 citation statements)

References 33 publications

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“…Pulmonary abnormalities after EP birth may clinically mimic pediatric asthma, and studies have reported increased respiratory symptoms and more hospital admissions, particularly during the first few years of life [ 33 – 35 ]. In this group of 11 year old children born EP in 1999–2000, current respiratory symptoms and use of asthma medication were reassuringly rare, also in those who were most immature at birth, contrasting some previous studies (8, 12, 36).…”

Section: Discussionmentioning

confidence: 99%

Children Born Preterm at the Turn of the Millennium Had Better Lung Function Than Children Born Similarly Preterm in the Early 1990s

et al. 2015

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ObjectiveCompare respiratory health in children born extremely preterm (EP) or with extremely low birthweight (ELBW) nearly one decade apart, hypothesizing that better perinatal management has led to better outcome.DesignFifty-seven (93%) of 61 eligible 11-year old children born in Western Norway in 1999–2000 with gestational age (GA) <28 weeks or birthweight <1000 gram (EP1999–2000) and matched term-controls were assessed with comprehensive lung function tests and standardized questionnaires. Outcome was compared with data obtained at 10 years of age from all (n = 35) subjects born at GA <29 weeks or birthweight <1001 gram within a part of the same region in 1991–92 (EP1991–1992) and their matched term-controls.ResultsEP1999–2000 had significantly reduced forced expiratory flow in 1 second (FEV1), FEV1 to forced vital capacity (FEV1/FVC) and forced expiratory flow between 25–75% of FVC (FEF25–75), with z-scores respectively -0.34, -0.50 and -0.61 below those of the term-control group, and more bronchial hyperresponsiveness to methacholine (dose-response-slope 13.2 vs. 3.5; p<0.001), whereas other outcomes did not differ. Low birthweight z-scores, but not neonatal bronchopulmonary dysplasia (BPD) or low GA, predicted poor outcome. For children with neonatal BPD, important lung-function variables were better in EP1999–2000 compared to EP1991–1992. In regression models, improvements were related to more use of antenatal corticosteroids and surfactant treatment in the EP1999–2000.ConclusionsSmall airway obstruction and bronchial hyperresponsiveness were still present in children born preterm in 1999–2000, but outcome was better than for children born similarly preterm in 1991–92, particularly after neonatal BPD. The findings suggest that better neonatal management not only improves survival, but also long-term pulmonary outcome.

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Section: Discussionmentioning

confidence: 99%

Children Born Preterm at the Turn of the Millennium Had Better Lung Function Than Children Born Similarly Preterm in the Early 1990s

et al. 2015

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“…Although respiratory symptoms in EPT-born children resemble asthma, the pathophysiology of lung disease after preterm birth is different which, for instance, is reflected in that the disease is unresponsive to inhaled corticosteroids 12 40–42. Their burden of respiratory symptoms may therefore be substantially higher, and more chronic16 and therefore more easily overlooked. For example, it is conceivable that poor sleep due to respiratory problems may cause daytime sleepiness and contribute to inattention and learning difficulties which are major challenges for children born EPT 43 44.…”

Section: Discussionmentioning

confidence: 99%

“…EPT was defined as gestational age (GA) <28 completed weeks or birth weight (BW) <1000 g. The children were prospectively followed from birth and assessed at 2, 5 and 11 years of age. Method for determination of GA and overall outcome in terms of mortality and morbidities until 11 years have been published previously 9 13–16. At 11 years, we obtained information on the families’ sociodemographic characteristics and lifestyles, and the children’s health, including sleep characteristics, behavioural issues and respiratory health, from postal questionnaires completed by the parents (for behaviour also the children’s teacher).…”

Section: Methodsmentioning

confidence: 99%

Sleep problems, behavioural problems and respiratory health in children born extremely preterm: a parental questionnaire study

Stangenes

Hysing

Elgen

et al. 2019

bmjpo

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ObjectiveTo explore whether children born extremely preterm (EPT) with different types of sleep problems had more behavioural and respiratory health problems than EPT children without sleep problems.DesignProspective, nationwide, questionnaire-based study. At 11 years of age, parents reported on four current sleep problems: difficulty falling asleep or frequent awakenings, snoring, daytime sleepiness and not recommended sleep duration (<9 hours). Behavioural problems were assessed by parents and teachers with the Strengths and Difficulties Questionnaire (SDQ). Parents assessed respiratory symptoms with the International Study of Asthma and Allergies in Childhood questionnaire and described use of asthma medication.SettingNorway.PatientsEPT children.Main outcome measuresSpecified sleep problems, behavioural problems and respiratory health.ResultsData were obtained from 216 of 372 (58 %) of eligible children. All four specified sleep problems were associated with significantly higher parent-reported SDQ total-score (OR 1.1 for all), and except for not recommended sleep duration, also with higher teacher-reported SDQ total-score (OR 1.1 for all). Daytime sleepiness was strongly associated with wheezing last 12 months (OR 3.4), disturbed sleep due to wheezing (OR 3.9), wheeze during or after exercise (OR 2.9), use of inhaled corticosteroids or oral leukotriene modifiers (OR 3.4) and use of bronchodilators (OR 3.9). Snoring was associated with wheezing during or after exercise (OR 2.8) and current asthma (OR 4.2).ConclusionEPT children with different types of sleep problems had more behavioural and respiratory health problems than EPT children without sleep problems.

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“…Bronchopulmonary dysplasia (BPD) was defined as still dependency on oxygen supplementation at 36 weeks' GA. The respiratory medical history of this cohort has been published (20,33). PDA was diagnosed at the discretion of the participating NICUs, with algorithms based on echocardiographic assessment of the left atrium to the aortic root ratio (above 1.3-1.5 depending on clinical situation) and clinical signs as listed by Evans in 1993 (bounding hyper dynamic pulses and signs of cardiac or respiratory insufficiency) (34).…”

Section: Sources and Collection Of Datamentioning

confidence: 99%

Voice and Exercise Related Respiratory Symptoms in Extremely Preterm Born Children After Neonatal Patent Ductus Arteriosus

et al. 2020

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Objective: To investigate voice characteristics and exercise related respiratory symptoms in extremely preterm born 11-year-old children, focusing particularly on associations with management of a patent ductus arteriosus (PDA). Study design: Prospective follow-up of all children born in Norway during 1999-2000 at gestational age <28 weeks or with birthweight <1,000 g. Neonatal data were obtained prospectively on custom-made registration forms completed by neonatologists. Voice characteristics and exercise related respiratory symptoms were obtained at 11 years by parental questionnaires. Result: Questionnaires were returned for 228/372 (61%) eligible children, of whom 137 had no history of PDA. PDA had been noted in 91 participants, of whom 36 had been treated conservatively, 21 with indomethacin, and 34 with surgery. Compared to the children treated with indomethacin or conservatively, the odds ratio (95% confidence interval) for the surgically treated children were 3.4 (1.3; 9.2) for having breathing problems during exercise, 16.9 (2.0; 143.0) for having a hoarse voice, 4.7 (1.3; 16.7) for a voice that breaks when shouting, 4.6 (1.1; 19.1) for a voice that disturbs singing, and 3.7 (1.1; 12.3) for problems shouting or speaking loudly. The significance of surgery per se was uncertain since the duration of mechanical ventilation was associated with the same outcomes. Conclusion: Extremely preterm born children with a neonatal history of PDA surgery had more problems with voice and breathing during exercise in mid-childhood than those whose PDA had been handled otherwise. The study underlines the causal heterogeneity of exercise related respiratory symptoms in preterm born children.

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Respiratory illness contributed significantly to morbidity in children born extremely premature or with extremely low birthweights in 1999–2000

Abstract: Respiratory morbidity decreased during the first five years of life but was still more common than expected. It was unrelated to BPD and gestational age at five years of age.

Cited by 23 publications

References 33 publications

Children Born Preterm at the Turn of the Millennium Had Better Lung Function Than Children Born Similarly Preterm in the Early 1990s

Children Born Preterm at the Turn of the Millennium Had Better Lung Function Than Children Born Similarly Preterm in the Early 1990s

Sleep problems, behavioural problems and respiratory health in children born extremely preterm: a parental questionnaire study

Voice and Exercise Related Respiratory Symptoms in Extremely Preterm Born Children After Neonatal Patent Ductus Arteriosus

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