AUTHOR=Chang Hung-Yang , Chang Jui-Hsing , Chi Hsin , Hsu Chyong-Hsin , Lin Chia-Ying , Jim Wai-Tim , Peng Chun-Chih 

TITLE=Reduced Lung Function at Preschool Age in Survivors of Very Low Birth Weight Preterm Infants

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.577673

DOI=10.3389/fped.2020.577673

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> Survivors of preterm birth are at risk of long-term respiratory consequences. The objective of this prospective study was to assess pulmonary function at preschool age of former very low birth weight (VLBW) preterm children.</p><p><bold>Methods:</bold> Lung function of children born preterm and term controls aged 5–6 years were assessed by spirometry. The results were converted to z-scores. A questionnaire regarding respiratory symptoms was completed. Associations to gestational age (GA), birth weight (BW), bronchopulmonary dysplasia (BPD), and perinatal factors were assessed.</p><p><bold>Results:</bold> In total, 85 VLBW preterm children and 29 term controls were studied. Of the preterm children, the mean GA was 28.6 ± 2.6 weeks and the mean BW was 1,047 ± 273 gm. Preterm children had significantly lower z-scores of forced expiratory volume in 1 s (FEV<sub>1</sub>), FEV<sub>1</sub>/forced vital capacity (FVC) ratio, and forced expiratory flow rate between 25–75% of FVC (FEF<sub>25−75</sub>), compared with term controls (−0.73 vs. 0.04, <italic>p</italic> = 0.002; −0.22 vs. 0.39, <italic>p</italic> = 0.003; −0.93 vs. 0.0, <italic>p</italic> &lt; 0.001; respectively). Further segregation of the preterm group revealed significantly impaired FEV<sub>1</sub>, FEF<sub>25−75</sub> in children at earlier gestation (≤ 28 weeks, <italic>n</italic> = 45), lighter at birth (≤ 1,000 g, <italic>n</italic> = 38), or with BPD (<italic>n</italic> = 55) compared with term controls (<italic>p</italic> &lt; 0.05). There were significant negative relationships between the severity of BPD with FEV<sub>1</sub>, FVC, and FEF<sub>25−75</sub> (<italic>p</italic> &lt; 0.05). However, no correlation between lung function measurements and respiratory symptoms was found.</p><p><bold>Conclusions:</bold> VLBW preterm infants have reduced lung function at preschool age, especially among those with younger GA, lower BW, and BPD. Additional long-term follow-up of respiratory outcomes are needed for this vulnerable population.</p>