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Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)
Author(s) -
Thunqvist Per,
Tufvesson Ellen,
Bjermer Leif,
Winberg Anna,
Fellman Vineta,
Domellöf Magnus,
Melén Erik,
Norman Mikael,
Hallberg Jenny
Publication year - 2018
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.23919
Subject(s) - medicine , lung function , cohort , cohort study , population , lung , pediatrics , environmental health
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 (FEV 1 , z‐score: −1.1, 95%CI: −1.4; −0.8), higher frequency‐dependence of resistance (R 5‐20 , 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 FEV 1 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.