Longitudinal impairment of lung function in school‐age children with extremely low birth weights

• Published in: Pediatric pulmonology 2017-06, Vol.52 (6), p.779-786
• Main Authors: Hirata, Katsuya, Nishihara, Masahiro, Kimura, Takeshi, Shiraishi, Jun, Hirano, Shinya, Kitajima, Hiroyuki, Fujimura, Masanori
• Format: Article
• Language: English
• Subjects: Age; bronchopulmonary dysplasia; Bronchopulmonary Dysplasia - physiopathology; Child; chronic lung disease; chronic obstructive pulmonary disease; extremely preterm infant; Female; Follow-Up Studies; Forced Expiratory Flow Rates; Forced Expiratory Volume; Humans; Infant, Extremely Low Birth Weight - physiology; Infant, Newborn; Lung - physiopathology; Male; Retrospective Studies; Spirometry; Vital Capacity
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.23669

OBJECTIVES To assess lung function and long‐term respiratory outcomes in extremely low birth weight (ELBW) survivors. WORKING HYPOTHESIS ELBW, especially with respiratory complications in the neonatal period, affects lung function at a later age. STUDY DESIGN Longitudinal retrospective study. PATIENT‐SUBJECT SELECTION Lung function was evaluated in 89 ELBW survivors (at ages 8 and 12) with or without a history of bronchopulmonary dysplasia (BPD) or a bubbly/cystic lung appearance in the neonatal period. METHODOLOGY FVC, FEV1, FEF50, and FEF75 were measured using spirometry. Two‐way repeated‐measures ANOVA was used to compare lung function and deterioration time course from 8 to 12 years of age. RESULTS Lung function variables were significantly and positively correlated between 8 and 12 years: %FVC (R2 = 0.558), %FEV1 (R2 = 0.539), %FEF50 (R2 = 0.412), and %FEF75 (R2 = 0.429). Lung function values were lower than Japanese reference values, especially in children with a history of severe BPD or a bubbly/cystic appearance. %FEV1 and FEV1/FVC ratio worsened from 8 to 12 years of age: 83.0 ± 17.0% versus 76.6 ± 17.8% (mean difference, 95%CI: −6.43, −9.10 to −3.75) and 84.0 ± 10.1% versus 78.2 ± 13.4% (mean difference, 95%CI: −5.82, −8.56 to −3.08), regardless of whether or not there was a history of neonatal respiratory disease. CONCLUSIONS In ELBW survivors, the obstructive pattern of lung function impairment deteriorated from 8 to 12 years of age, independent of the presence of severe BPD or bubbly/cystic appearance in the neonatal period.