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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 ; 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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organization
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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
external identifiers
  • scopus:85034238979
ISSN
8755-6863
DOI
10.1002/ppul.23919
language
English
LU publication?
yes
id
20db9d64-d425-466f-b79e-00a9ccc68c66
date added to LUP
2019-07-01 08:54:25
date last changed
2019-09-11 04:20:59
@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},
  keyword      = {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},
  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},
  volume       = {53},
  year         = {2018},
}