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Lung function after extremely preterm birth-A population-based cohort study (EXPRESS)

Thunqvist, Per ; Tufvesson, Ellen LU ; Bjermer, Leif LU ; Winberg, Anna ; Fellman, Vineta LU orcid ; Domellöf, Magnus ; Melén, Erik ; Norman, Mikael and Hallberg, Jenny (2018) In Pediatric Pulmonology 53(1). p.64-72
Abstract

BACKGROUND AND OBJECTIVES: Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation).

METHODS: In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed.

RESULTS: Children born extremely preterm had lower forced vital capacity (FVC,... (More)

BACKGROUND AND OBJECTIVES: Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation).

METHODS: In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed.

RESULTS: Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L-1  · s-1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L-1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls.

CONCLUSION: Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Asthma/physiopathology, Bronchopulmonary Dysplasia/physiopathology, Child, Cohort Studies, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Infant, Extremely Premature/physiology, Infant, Newborn, Lung/physiopathology, Male, Premature Birth/physiopathology, Respiratory Function Tests, Spirometry, Vital Capacity
in
Pediatric Pulmonology
volume
53
issue
1
pages
64 - 72
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:29152899
  • scopus:85034238979
ISSN
8755-6863
DOI
10.1002/ppul.23919
language
English
LU publication?
yes
additional info
© 2017 Wiley Periodicals, Inc.
id
20db9d64-d425-466f-b79e-00a9ccc68c66
date added to LUP
2019-07-01 08:54:25
date last changed
2022-06-21 00:15:10
@article{20db9d64-d425-466f-b79e-00a9ccc68c66,
  abstract     = {{<p>BACKGROUND AND OBJECTIVES: Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation).</p><p>METHODS: In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed.</p><p>RESULTS: Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L-1  · s-1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L-1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls.</p><p>CONCLUSION: Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up.</p>}},
  author       = {{Thunqvist, Per and Tufvesson, Ellen and Bjermer, Leif and Winberg, Anna and Fellman, Vineta and Domellöf, Magnus and Melén, Erik and Norman, Mikael and Hallberg, Jenny}},
  issn         = {{8755-6863}},
  keywords     = {{Asthma/physiopathology; Bronchopulmonary Dysplasia/physiopathology; Child; Cohort Studies; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Infant, Extremely Premature/physiology; Infant, Newborn; Lung/physiopathology; Male; Premature Birth/physiopathology; Respiratory Function Tests; Spirometry; Vital Capacity}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{64--72}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Pediatric Pulmonology}},
  title        = {{Lung function after extremely preterm birth-A population-based cohort study (EXPRESS)}},
  url          = {{http://dx.doi.org/10.1002/ppul.23919}},
  doi          = {{10.1002/ppul.23919}},
  volume       = {{53}},
  year         = {{2018}},
}