Early Asthma Symptoms Linked to Lung Function in Adolescents Born Preterm

Early childhood asthma symptoms may be independent factors associated with alterations in lung function in adolescents who are born preterm, according to a study published by Thorax

Researchers conducted a prospective study from birth to adolescence in individuals born very prematurely who are currently participating in the Etude Epidémiologique sure les Petits Ages Gestationnels (EPIPAGE; ClinicalTrials.gov Identifier: NCT01424553) cohort. A total of 304 adolescents born very prematurely and 47 children born at term were included in the study with 273 and 44 having completed prebronchodilator spirometry, respectively. The purpose of the study was to evaluate the relationship between lung function and asthma from birth to adolescence in individuals born very prematurely.

The researchers found that preterm-born children had significantly more frequent preschool wheeze compared with children born at term (relative risk [RR], 1.71; 95% CI,1.01-2.90; P =.03), with a higher prevalence found in those born both preterm and with bronchopulmonary dysplasia (BPD) compared with those without BPD (RR, 1.4; 95% CI,0.98-1.90; P =.04)]. In addition, boys were found to have a higher prevalence of preschool wheezing, and children with atopy had a higher risk for asthma developing at school age and as teenagers.

Of all preterm children, an improvement of forced expiratory volume in 1 second (FEV₁) by 12% or more was seen in only 7%, and there was no correlation between FEV₁ and fractional exhaled nitric oxide (P =.34) observed in those born prematurely. The only perinatal variable in preterm infants that was independently associated with FEV₁ at adolescence was BPD (P <.001).

Researchers concluded that prematurity and BPD lead to lower function at adolescence, and wheezing episodes during the preschool period are associated with late lung function. Clinicians should be vigilant in assessing and evaluating lung function in premature infants because they are at higher risk for late and lower lung function as a result of their premature birth.

Reference

Hadchouel A, Rousseau J, Rozé J-C, et al. Association between asthma and lung function in adolescents born very preterm: results of the EPIPAGE cohort study [published online March 31, 2018]. Thorax. doi:10.1136/thoraxjnl-2017-211115