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Small for gestational age birth may increase airflow limitation in bronchopulmonary dysplasia
Author(s) -
Kim Yoon Hee,
Kim Kyung Won,
Eun Ho Sun,
Shin Jung Eun,
Sol In Suk,
Kim Soo Yeon,
Kim Young Suh,
Sohn Myung Hyun,
Namgung Ran
Publication year - 2020
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.24580
Subject(s) - bronchopulmonary dysplasia , medicine , gestational age , nitrogen washout , small for gestational age , ventilation (architecture) , pediatrics , functional residual capacity , lung volumes , obstetrics , pregnancy , lung , mechanical engineering , genetics , engineering , biology
Objectives To determine significant indices for assessing the pulmonary function of infants according to bronchopulmonary dysplasia (BPD) severity and to evaluate whether small for gestational age (SGA) could affect pulmonary function in BPD. Methods We evaluated 117 preterm infants who had undergone tidal breathing flow‐volume loop and multiple‐breath washout analyses within 7 months after birth. We categorized preterm infants according to BPD severity into mild/moderate BPD ( n = 86), severe BPD ( n = 21), and without BPD ( n = 10) and the presence of SGA or appropriate gestational age (AGA) using the Fenton growth chart. We evaluated nine healthy term infants as controls. Results The tidal breathing ratio (time to peak expiratory flow/expiratory time [ t PEF / t E ]) was significantly lower in infants with severe BPD than in those with mild/moderate BPD. Lung clearance index (LCI) was not different based on BPD severity. In the correlation analysis after adjusting for gestational age and sex, t PEF / t E was correlated with the duration of mechanical ventilation ( r = −0.347, P < .001) and the duration of oxygen supply ( r = −0.248, P = .013) in infants with BPD. The proportion of “lower t PEF / t E ,” defined as below the cut‐off value, was greater in SGA infants ( P = .017), while no significant difference was seen in the percentage of “higher LCI,” defined as above the cut‐off value between SGA and AGA infants. Conclusions In infants with BPD, t PEF / t E could be a useful pulmonary index which shows lower values in severe BPD. The finding of SGA in infants with BPD could be associated with poor pulmonary function related to the t PEF / t E values.