Children who were born preterm in the surfactant era had an increased likelihood of exhibiting impaired lung function compared with healthy term children, according to a recent study published in the Lancet Child & Adolescent Health.

Lung function of preterm children (n=200) with and without bronchopulmonary dysplasia was determined by multiple measurements of spirometry, oscillatory mechanics, gas exchange, lung volume, and respiratory symptoms taken from 4 to 12 years of age. Results were then compared with those of healthy term children (n=67).

Of the children born preterm, 126 had bronchopulmonary dysplasia, defined as requiring at least 28 days of supplemental oxygen. Preterm children had declines in spirometry z-scores between early childhood and midchildhood compared with healthy term children, regardless of the presence or absence of bronchopulmonary dysplasia.


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For children with bronchopulmonary dysplasia, measurements of respiratory system mechanics had decreasing trajectories over time. Respiratory system reactance at 8 Hz decreased by −0.05 z-scores per year (95% CI, −0.08 to −0.01; P =.006), and area under the reactance curve increased by 0.04 z-scores per year (95% CI, 0.01-0.07; P =.023) compared with healthy term children. Furthermore, preterm born children had a high burden of respiratory symptoms, with 70% of preterm children reporting wheeze during their lifetimes.

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The authors noted that their study presents concerns about the long-term lung health of children born very preterm.

“[T]he respiratory sequelae following preterm birth can no longer be of concern just for paediatricians, but rather necessitate a co-ordinated life-course approach to understand the natural history of lung disease following preterm birth,” they concluded.

Reference

Simpson S, Turkovik L, Wilson A, et al. Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort studyLancet Child Adolesc Health. 2018;2(5):350-359.