Are preterm-born survivors at risk of long-term respiratory disease?

Kaczmarczyk, Katarzyna; Wiszomirska, Ida; Szturmowicz, Magdalena; Magiera, Andrzej; Błażkiewicz, Michalina

doi:10.1177/1753465817710595

Cited by 13 publications

(20 citation statements)

References 50 publications

(74 reference statements)

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“…Similar to the study by Broström et al, the study by Kaczmarczyk et al examined whether preterm birth was a risk for the development of respiratory disease in later life. 30 , 41 The results indicated, unlike the study by Broström et al, that there were no significant differences between preterm-born adults and the reference group of adults in terms of respiratory parameters. 30 One limitation to the study by Kaczmarczyk et al was the relatively small number of subjects included in the study and that may be the reason why there were no significant findings in respiratory function in preterm-born individuals compared with healthy individuals.…”

Section: Discussioncontrasting

confidence: 66%

“… 30 One limitation to the study by Kaczmarczyk et al was the relatively small number of subjects included in the study and that may be the reason why there were no significant findings in respiratory function in preterm-born individuals compared with healthy individuals. 41 Whether preterm birth is also a risk factor for COPD, therefore, remains uncertain, because evidence on the association is not conclusive.…”

Section: Discussionmentioning

confidence: 99%

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Early life insults as determinants of chronic obstructive pulmonary disease in adult life

Savran¹,

Ulrik²

2018

COPD

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BackgroundEarly life events may predispose to the development of chronic lung disease in adulthood.AimTo provide an update on current knowledge of early nongenetic origins of COPD.Materials and methodsSystematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total of 16 studies, comprising 69,365 individuals, met the predefined criteria and were included in the present review. Studies have shown that in utero tobacco exposure, low birth weight, preterm birth, and respiratory diseases, primarily asthma and pneumonia, in early childhood are associated with lung function impairment later in childhood, and by that predispose to subsequent development of COPD, although the causal association between childhood respiratory diseases and COPD has been questioned in one study. Environmental tobacco exposure has also been shown to have negative impact on lung function in childhood possibly leading to COPD in adulthood, although it is at present not possible to clearly distinguish between the impact of active and the environmental tobacco exposure on subsequent development of COPD.ConclusionTobacco exposure in utero and early life is a risk factor for subsequent development of COPD. Furthermore, low birth weight, lower respiratory tract infections and asthma, including wheezy bronchitis, in childhood also seem to be important determinants for later development of COPD. Early life insults may, therefore, be crucial to COPD development.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Early life insults as determinants of chronic obstructive pulmonary disease in adult life

Savran¹,

Ulrik²

2018

COPD

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“…There was a wide gestational age range in our participants with the majority of our preterm-born individuals born moderate to late preterm, which reflects the demographic of the general preterm population. 32 Although this makes our findings more relevant to a larger proportion of the population, larger studies will be needed to fully explore to what extent the severity of the LV systolic response to exercise is altered specifically in very and extreme preterm-born adults, who are at greater risk of perinatal complications. Finally, while pulmonary function and objective measurement of physical activity (accelerometry) were included in this analysis, direct assessment of pulmonary gas diffusion and broader ranging lifestyle characteristics, including historical physical activity profile, were not assessed.…”

Section: Discussionmentioning

confidence: 98%

“…Overall, the moderately premature gestational age of the preterm-born group makes our results more broadly relevant, given that this reflects the demographic of the majority of preterm births. 32 The reduced association between physical activity and exercise capacity in the preterm group suggests that prematurity may alter cardiovascular adaptation to aerobic training and require tailored approaches to lifestyle intervention, though randomized control trials will be needed to assess this. The finding that a lower myocardial functional reserve seen in those young adults born preterm explains a significant proportion of the lower peak VO 2 and slower HRR adds further clinical relevance to the altered preterm cardiac phenotype.…”

Section: Discussionmentioning

confidence: 99%

Impaired myocardial reserve underlies reduced exercise capacity and heart rate recovery in preterm-born young adults

Huckstep

Burchert

Williamson

et al. 2020

European Heart Journal - Cardiovascular Imaging

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Aims We tested the hypothesis that the known reduction in myocardial functional reserve in preterm-born young adults is an independent predictor of exercise capacity (peak VO2) and heart rate recovery (HRR). Methods and results We recruited 101 normotensive young adults (n = 47 born preterm; 32.8 ± 3.2 weeks’ gestation and n = 54 term-born controls). Peak VO2 was determined by cardiopulmonary exercise testing (CPET), and lung function assessed using spirometry. Percentage predicted values were then calculated. HRR was defined as the decrease from peak HR to 1 min (HRR1) and 2 min of recovery (HRR2). Four-chamber echocardiography views were acquired at rest and exercise at 40% and 60% of CPET peak power. Change in left ventricular ejection fraction from rest to each work intensity was calculated (EFΔ40% and EFΔ60%) to estimate myocardial functional reserve. Peak VO2 and per cent of predicted peak VO2 were lower in preterm-born young adults compared with controls (33.6 ± 8.6 vs. 40.1 ± 9.0 mL/kg/min, P = 0.003 and 94% ± 20% vs. 108% ± 25%, P = 0.001). HRR1 was similar between groups. HRR2 decreased less in preterm-born young adults compared with controls (−36 ± 13 vs. −43 ± 11 b.p.m., P = 0.039). In young adults born preterm, but not in controls, EFΔ40% and EFΔ60% correlated with per cent of predicted peak VO2 (r2 = 0.430, P = 0.015 and r2 = 0.345, P = 0.021). Similarly, EFΔ60% correlated with HRR1 and HRR2 only in those born preterm (r2 = 0.611, P = 0.002 and r2 = 0.663, P = 0.001). Conclusions Impaired myocardial functional reserve underlies reductions in peak VO2 and HRR in young adults born moderately preterm. Peak VO2 and HRR may aid risk stratification and treatment monitoring in this population.

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“…3 Additionally, recurrent respiratory tract infections in early childhood, chronic cough during childhood, tobacco exposure in utero, low birth weight, preterm birth, and genetic factors were significantly associated with COPD. [37][38][39][40] Our study revealed that approximately 10% of COPD patients were exposed to these unusual risk factors. We identified that these COPD patients have obvious respiratory symptoms and create a heavy disease burden.…”

mentioning

confidence: 71%

<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

Duan¹,

Cheng²,

Zeng³

et al. 2020

COPD

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Purpose: Tobacco smoking, biomass smoke, and occupational exposure are the main risk factors for chronic obstructive pulmonary disease (COPD). The present study analyzes data on exposure to these factors in a cohort of patients with COPD and assesses their differences in demographic and clinical characteristics. Patients and Methods: The cross-sectional observational study was conducted from November 2016 to December 2019. Inclusion criteria were patients aged over 40 years old with post-bronchodilator forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC) <0.7. At baseline, demographic features and exposure history were recorded. Moreover, respiratory symptoms were assessed by the COPD Assessment Test (CAT) and modified Medical Research Council scale (mMRC). A generalized linear mixed model was used to adjust for potential confounders. Results: A total of 5183 patients with COPD were included in the final analysis. The results demonstrate that exposure to tobacco combined with other risk factors resulted in significantly higher CAT scores (16.0 ± 6.7 vs 15.3 ± 6.3, P = 0.003) and more severe dyspnea (patients with mMRC ≥ 2, 71.5% vs 61.6%, P < 0.001) than exposure to tobacco alone. In addition, COPD patients with biomass smoke exposure alone had higher CAT scores than patients with only tobacco or occupational exposure (17.5 ± 6.3 vs 15.3 ± 6.3, and 15.2 ± 6.3, respectively, P < 0.05 for each comparison) and were more likely to be female and older. In addition, COPD patients who suffered from occupational exposure developed more severe dyspnea than those exposed to tobacco alone (70.8% vs 61.6%, P < 0.05), as did those exposed to biomass smoke alone (74.2% vs 61.6%, P < 0.05). This difference remained strong even after adjustment for potential confounders. Conclusion: There are significant demographic and clinical differences among COPD patients with tobacco smoking, biomass smoke, and occupational exposures.

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Are preterm-born survivors at risk of long-term respiratory disease?

Cited by 13 publications

References 50 publications

Early life insults as determinants of chronic obstructive pulmonary disease in adult life

Early life insults as determinants of chronic obstructive pulmonary disease in adult life

Impaired myocardial reserve underlies reduced exercise capacity and heart rate recovery in preterm-born young adults

<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

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