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Lung function in a cohort of 5‐year‐old children born very preterm
Author(s) -
Lombardi Enrico,
Fainardi Valentina,
Calogero Claudia,
Puglia Monia,
Voller Fabio,
Cuttini Marina,
Rusconi Franca
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.24179
Subject(s) - medicine , bronchopulmonary dysplasia , pediatrics , cohort , respiratory system , gestational age , prospective cohort study , lung , cohort study , lung function , pregnancy , genetics , biology
Objective We assessed lung function and respiratory health in an area‐based prospective cohort of preschool children born very preterm. Design Lung function was measured by interrupter respiratory resistance (Rint) and forced oscillation technique (FOT) (respiratory resistance (Rrs8), reactance (Xrs8), and area under the reactance curve (AX)) at a median age of 5.2 years in a cohort of 194 children born at 22‐31 weeks of gestational age (GA) in Tuscany, Italy. Respiratory symptoms and hospitalizations were also assessed. Results Mean (SD) lung function Z‐scores were impaired in preterm children for Rint (0.72 (1.13)), Xrs8 (‐0.28 (1.34)), and AX (0.29 (1.41)). However, only a relatively small proportion of children (14.5‐17.4%) had values beyond the 95th centile or below the 5th. Children with bronchopulmonary dysplasia (BPD) ( n = 24) had slightly but not significantly impaired lung function indices in comparison with those without BPD ( n = 170). In a multivariable analysis, lower GA was associated with worse lung function indices. Fifty‐five percent of children had a history of wheezing ever and 21% had been hospitalized in their lifetime because of lower respiratory infections; 31% had wheezing in the last 12 months and this was associated with increased Rrs8 ( P = 0.04) and AX ( P = 0.08), and with decreased Xrs8 ( P = 0.04) Z‐scores. Conclusions Irrespectively of BPD preschool children born very preterm had impaired lung function indices, as measured by Rint and FOT, and a slightly higher burden of respiratory problems than the general population. GA seems to be crucial for lung development.