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Longitudinal impairment of lung function in school‐age children with extremely low birth weights
Author(s) -
Hirata Katsuya,
Nishihara Masahiro,
Kimura Takeshi,
Shiraishi Jun,
Hirano Shinya,
Kitajima Hiroyuki,
Fujimura Masanori
Publication year - 2017
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.23669
Subject(s) - medicine , bronchopulmonary dysplasia , pediatrics , spirometry , lung , pulmonary function testing , lung function , gestational age , pregnancy , asthma , genetics , biology
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, FEV 1 , FEF 50 , and FEF 75 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 ( R 2 = 0.558), %FEV 1 ( R 2 = 0.539), %FEF 50 ( R 2 = 0.412), and %FEF 75 ( R 2 = 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. %FEV 1 and FEV 1 /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.