Comparative analysis of pulmonary function in children born preterm and full-term at 6–9 years of age

Abstract Objective: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. Methods: This is a cross-sectional study with 6–9-year-old children submitted to measurement of air...

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Published in:Revista paulista de pediatria 2023-01, Vol.41
Main Authors: Gonzaga, Ana Damaris, Davidson, Josy, Goulart, Ana Lucia, Barros, Marina Carvalho de Moraes, Chiba, Sonia Mayumi, Santos, Amélia Miyashiro Nunes dos
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description Abstract Objective: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. Methods: This is a cross-sectional study with 6–9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age
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Methods: This is a cross-sectional study with 6–9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered. Results: A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones. Conclusions: Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term. RESUMO Objetivo: Comparar parâmetros de função pulmonar e a prevalência de função pulmonar alterada em crianças nascidas pré-termo e a termo, utilizando a referência Global Lung Function Initiative. Métodos: Estudo transversal com crianças de 6–9 anos submetidas à medida de resistência de vias aéreas (Rint) segundo o American Thoracic Society and the European Respiratory Society Technical Statement. Como critérios de inclusão, entre o grupo pré-termo, estavam os nascidos com idade gestacional <37 semanas e peso <2000g; e entre o grupo termo, escolares de duas escolas públicas do município de São Paulo, nascidos a termo com peso >2500g, pareados por sexo e idade com o grupo pré-termo. Excluíram-se malformações congênitas, déficit cognitivo e problemas respiratórios havia menos de 15 dias. Resultados: Incluíram-se 112 crianças em cada grupo. Os prematuros (46,4% masculinos) apresentaram idade gestacional de 30,8±2,8 semanas e peso de 1349±334g. Entre eles, 46,4% tiveram síndrome de desconforto respiratório, 19,6% displasia broncopulmonar, e 65,2% receberam ventilação mecânica na unidade neonatal. À inclusão no estudo, os dois grupos apresentaram idade e dados antropométricos semelhantes. Os valores (escores Z) em nascidos pré-termo e a termo foram, respectivamente: Rint (0,13±2,24 vs. -1,02±1,29; p<0,001), capacidade vital forçada (CVF) (-0,39±1,27 vs. -0,15±1,03; p=0,106), volume expiratório forçado no primeiro segundo (VEF1)/CVF (-0,23±1,22 vs. 0,14±1,11; p=0,003), VEF1 (-0,48±1,29 vs. -0,04±1,08; p=0,071) e fluxo expiratório forçado em 25–75% da capacidade vital (FEF25-75) (1,16±1,37 vs. 2,08±1,26; p=0,005). A prevalência de alterações na resistência de vias aéreas (16,1 vs. 1,8%, p<0,001) e na espirometria (26,8 vs. 13,4%, p=0,012) foi maior nos prematuros. Conclusões: As crianças nascidas pré-termo apresentaram maior prevalência de alteração pulmonar, maiores escores Z de resistência de vias aéreas e menores escores Z de VEF1/CVF e FEF25-75 quando comparadas às nascidas a termo.]]></description><identifier>ISSN: 0103-0582</identifier><identifier>EISSN: 1984-0462</identifier><identifier>DOI: 10.1590/1984-0462/2023/41/2021294</identifier><identifier>PMID: 36102403</identifier><language>eng</language><publisher>Sociedade de Pediatria de São Paulo</publisher><subject>Original</subject><ispartof>Revista paulista de pediatria, 2023-01, Vol.41</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c383t-3d5e61bc50a223a6a5ca375a6538e3d469a6da87feecc75a8418e26eb1a44e9f3</cites><orcidid>0000-0002-8407-1556 ; 0000-0001-6989-3474 ; 0000-0003-0987-177X ; 0000-0003-4004-1889 ; 0000-0003-4359-370X ; 0000-0001-5894-5515</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462401/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462401/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids></links><search><creatorcontrib>Gonzaga, Ana Damaris</creatorcontrib><creatorcontrib>Davidson, Josy</creatorcontrib><creatorcontrib>Goulart, Ana Lucia</creatorcontrib><creatorcontrib>Barros, Marina Carvalho de Moraes</creatorcontrib><creatorcontrib>Chiba, Sonia Mayumi</creatorcontrib><creatorcontrib>Santos, Amélia Miyashiro Nunes dos</creatorcontrib><title>Comparative analysis of pulmonary function in children born preterm and full-term at 6–9 years of age</title><title>Revista paulista de pediatria</title><description><![CDATA[Abstract Objective: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. Methods: This is a cross-sectional study with 6–9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered. Results: A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones. Conclusions: Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term. RESUMO Objetivo: Comparar parâmetros de função pulmonar e a prevalência de função pulmonar alterada em crianças nascidas pré-termo e a termo, utilizando a referência Global Lung Function Initiative. Métodos: Estudo transversal com crianças de 6–9 anos submetidas à medida de resistência de vias aéreas (Rint) segundo o American Thoracic Society and the European Respiratory Society Technical Statement. Como critérios de inclusão, entre o grupo pré-termo, estavam os nascidos com idade gestacional <37 semanas e peso <2000g; e entre o grupo termo, escolares de duas escolas públicas do município de São Paulo, nascidos a termo com peso >2500g, pareados por sexo e idade com o grupo pré-termo. Excluíram-se malformações congênitas, déficit cognitivo e problemas respiratórios havia menos de 15 dias. Resultados: Incluíram-se 112 crianças em cada grupo. Os prematuros (46,4% masculinos) apresentaram idade gestacional de 30,8±2,8 semanas e peso de 1349±334g. Entre eles, 46,4% tiveram síndrome de desconforto respiratório, 19,6% displasia broncopulmonar, e 65,2% receberam ventilação mecânica na unidade neonatal. À inclusão no estudo, os dois grupos apresentaram idade e dados antropométricos semelhantes. Os valores (escores Z) em nascidos pré-termo e a termo foram, respectivamente: Rint (0,13±2,24 vs. -1,02±1,29; p<0,001), capacidade vital forçada (CVF) (-0,39±1,27 vs. -0,15±1,03; p=0,106), volume expiratório forçado no primeiro segundo (VEF1)/CVF (-0,23±1,22 vs. 0,14±1,11; p=0,003), VEF1 (-0,48±1,29 vs. -0,04±1,08; p=0,071) e fluxo expiratório forçado em 25–75% da capacidade vital (FEF25-75) (1,16±1,37 vs. 2,08±1,26; p=0,005). A prevalência de alterações na resistência de vias aéreas (16,1 vs. 1,8%, p<0,001) e na espirometria (26,8 vs. 13,4%, p=0,012) foi maior nos prematuros. Conclusões: As crianças nascidas pré-termo apresentaram maior prevalência de alteração pulmonar, maiores escores Z de resistência de vias aéreas e menores escores Z de VEF1/CVF e FEF25-75 quando comparadas às nascidas a termo.]]></description><subject>Original</subject><issn>0103-0582</issn><issn>1984-0462</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpVkN1Kw0AQhRdRbK2-w_oAsfuXbfZGkOIfFLzR62WymbQrySZs0kLvfAff0CcxsaXg1WHmzDkwHyG3nN3x1LA5N5lKmNJiLpiQc8VH5cKoMzI9eedkyjiTCUszMSFXXffJmGZcLy7JRGrOhGJyStbLpm4hQu93SCFAte98R5uSttuqbgLEPS23wfW-CdQH6ja-KiIGmjcx0DZij7EecsVwVVXJYeqp_vn6NnSPEP-6YI3X5KKEqsObo87Ix9Pj-_IlWb09vy4fVomTmewTWaSoee5SBkJI0JA6kIsUdCozlIXSBnQB2aJEdG7YZ4pnKDTmHJRCU8oZuT_0ttu8xsJh6CNUto2-Hn6xDXj73wl-Y9fNzpoBmWJ8KDCHAhebrotYnrKc2ZG-HQnbkbAd6VvF7ZG-_AX0VXpV</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Gonzaga, Ana Damaris</creator><creator>Davidson, Josy</creator><creator>Goulart, Ana Lucia</creator><creator>Barros, Marina Carvalho de Moraes</creator><creator>Chiba, Sonia Mayumi</creator><creator>Santos, Amélia Miyashiro Nunes dos</creator><general>Sociedade de Pediatria de São Paulo</general><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8407-1556</orcidid><orcidid>https://orcid.org/0000-0001-6989-3474</orcidid><orcidid>https://orcid.org/0000-0003-0987-177X</orcidid><orcidid>https://orcid.org/0000-0003-4004-1889</orcidid><orcidid>https://orcid.org/0000-0003-4359-370X</orcidid><orcidid>https://orcid.org/0000-0001-5894-5515</orcidid></search><sort><creationdate>20230101</creationdate><title>Comparative analysis of pulmonary function in children born preterm and full-term at 6–9 years of age</title><author>Gonzaga, Ana Damaris ; Davidson, Josy ; Goulart, Ana Lucia ; Barros, Marina Carvalho de Moraes ; Chiba, Sonia Mayumi ; Santos, Amélia Miyashiro Nunes dos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-3d5e61bc50a223a6a5ca375a6538e3d469a6da87feecc75a8418e26eb1a44e9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonzaga, Ana Damaris</creatorcontrib><creatorcontrib>Davidson, Josy</creatorcontrib><creatorcontrib>Goulart, Ana Lucia</creatorcontrib><creatorcontrib>Barros, Marina Carvalho de Moraes</creatorcontrib><creatorcontrib>Chiba, Sonia Mayumi</creatorcontrib><creatorcontrib>Santos, Amélia Miyashiro Nunes dos</creatorcontrib><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Revista paulista de pediatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonzaga, Ana Damaris</au><au>Davidson, Josy</au><au>Goulart, Ana Lucia</au><au>Barros, Marina Carvalho de Moraes</au><au>Chiba, Sonia Mayumi</au><au>Santos, Amélia Miyashiro Nunes dos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative analysis of pulmonary function in children born preterm and full-term at 6–9 years of age</atitle><jtitle>Revista paulista de pediatria</jtitle><date>2023-01-01</date><risdate>2023</risdate><volume>41</volume><issn>0103-0582</issn><eissn>1984-0462</eissn><abstract><![CDATA[Abstract Objective: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. Methods: This is a cross-sectional study with 6–9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered. Results: A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones. Conclusions: Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term. RESUMO Objetivo: Comparar parâmetros de função pulmonar e a prevalência de função pulmonar alterada em crianças nascidas pré-termo e a termo, utilizando a referência Global Lung Function Initiative. Métodos: Estudo transversal com crianças de 6–9 anos submetidas à medida de resistência de vias aéreas (Rint) segundo o American Thoracic Society and the European Respiratory Society Technical Statement. Como critérios de inclusão, entre o grupo pré-termo, estavam os nascidos com idade gestacional <37 semanas e peso <2000g; e entre o grupo termo, escolares de duas escolas públicas do município de São Paulo, nascidos a termo com peso >2500g, pareados por sexo e idade com o grupo pré-termo. Excluíram-se malformações congênitas, déficit cognitivo e problemas respiratórios havia menos de 15 dias. Resultados: Incluíram-se 112 crianças em cada grupo. Os prematuros (46,4% masculinos) apresentaram idade gestacional de 30,8±2,8 semanas e peso de 1349±334g. Entre eles, 46,4% tiveram síndrome de desconforto respiratório, 19,6% displasia broncopulmonar, e 65,2% receberam ventilação mecânica na unidade neonatal. À inclusão no estudo, os dois grupos apresentaram idade e dados antropométricos semelhantes. Os valores (escores Z) em nascidos pré-termo e a termo foram, respectivamente: Rint (0,13±2,24 vs. -1,02±1,29; p<0,001), capacidade vital forçada (CVF) (-0,39±1,27 vs. -0,15±1,03; p=0,106), volume expiratório forçado no primeiro segundo (VEF1)/CVF (-0,23±1,22 vs. 0,14±1,11; p=0,003), VEF1 (-0,48±1,29 vs. -0,04±1,08; p=0,071) e fluxo expiratório forçado em 25–75% da capacidade vital (FEF25-75) (1,16±1,37 vs. 2,08±1,26; p=0,005). A prevalência de alterações na resistência de vias aéreas (16,1 vs. 1,8%, p<0,001) e na espirometria (26,8 vs. 13,4%, p=0,012) foi maior nos prematuros. Conclusões: As crianças nascidas pré-termo apresentaram maior prevalência de alteração pulmonar, maiores escores Z de resistência de vias aéreas e menores escores Z de VEF1/CVF e FEF25-75 quando comparadas às nascidas a termo.]]></abstract><pub>Sociedade de Pediatria de São Paulo</pub><pmid>36102403</pmid><doi>10.1590/1984-0462/2023/41/2021294</doi><orcidid>https://orcid.org/0000-0002-8407-1556</orcidid><orcidid>https://orcid.org/0000-0001-6989-3474</orcidid><orcidid>https://orcid.org/0000-0003-0987-177X</orcidid><orcidid>https://orcid.org/0000-0003-4004-1889</orcidid><orcidid>https://orcid.org/0000-0003-4359-370X</orcidid><orcidid>https://orcid.org/0000-0001-5894-5515</orcidid><oa>free_for_read</oa></addata></record>
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title Comparative analysis of pulmonary function in children born preterm and full-term at 6–9 years of age
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