Premium
Lung function at 6 and 18 months after preterm birth in relation to severity of bronchopulmonary dysplasia
Author(s) -
Thunqvist Per,
Gustafsson Per,
Norman Mikael,
Wickman Magnus,
Hallberg Jenny
Publication year - 2015
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23090
Subject(s) - bronchopulmonary dysplasia , medicine , wheeze , functional residual capacity , gestational age , lung volumes , pulmonary function testing , lung , respiratory system , gestation , vital capacity , pediatrics , cardiology , lung function , pregnancy , diffusing capacity , genetics , biology
Summary Many preterm infants with bronchopulmonary dysplasia (BPD) demonstrate impaired lung function and respiratory symptoms during infancy. The relationships between initial BPD severity, lung function and respiratory morbidity are not fully understood. We aimed to investigate the association between BPD severity and subsequent lung function and whether lung function impairment is related to respiratory morbidity. Study design and methods In this longitudinal cohort study, 55 infants born preterm (23–30 weeks of gestation) with mild or moderate/severe BPD, based on oxygen requirement at 36 gestational weeks, were followed up at 6 and 18 months postnatal age. Respiratory symptoms, such as recurrent or chronic chough and wheeze, were noted and patient records were scrutinized. Lung function was assessed by passive lung mechanics, whole body plethysmography, and tidal and raised volume rapid thoraco‐abdominal compression techniques . Results were related to published normative values. Results Besides residual functional capacity (FRC) and respiratory system compliance (C so ) assessed at 18 months, all measures of lung function were significantly below normative values. Moderate/severe BPD differed significantly from mild BPD only with respect to reduced C so . At follow‐up at 6 and 18 months, participants with respiratory symptoms showed lower; maximal forced expiratory flow at FRC (V ′ maxFRC) ( P = 0.006, P = 0.001), forced mid‐expiratory flows (MEF 50 ) ( P = 0.006, P = 0.048), and C so ( P = 0.004, P = 0.015) as compared to participants without symptoms. Conclusions In the present study BPD severity did not predict lung function, but may be associated with impaired alveolarization, indicated by reduced C so . Respiratory morbidity was associated with reduced airway function and respiratory compliance in infancy after preterm birth. Pediatr Pulmonol. 2015; 50:978–986. © 2014 Wiley Periodicals, Inc.