Long-term expiratory airflow of infants born moderate-late preterm: A systematic review and meta-analysis

Berry, Cassidy Du; Nesci, Christopher; Cheong, Jeanie L.Y.; FitzGerald, Tara L; Mainzer, Rheanna; Ranganathan, Sarath; Doyle, Lex W.; Vrijlandt, Elianne J.L.E.; Welsh, Liam

doi:10.1016/j.eclinm.2022.101597

Cited by 22 publications

(11 citation statements)

References 51 publications

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“…The systematic review and meta-analysis indicate that infants born moderate-late preterm (32–37 weeks) had poorer expiratory airflows compared to term-born infants, as per established norms [ 37 ]. Preterm-born participants have lower z-scores for FEV 1 , FVC, FEV 1 /FVC, and FEF25-75% than controls.…”

Section: Discussionmentioning

confidence: 99%

Long-term pulmonary outcomes of young adults born prematurely: a Polish prospective cohort study PREMATURITAS 20

Walicka-Serzysko,

Postek,

Borawska-Kowalczyk

et al. 2024

BMC Pulm Med

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Background The long-term consequences of prematurity are often not sufficiently recognized. To address this gap, a prospective cohort study, which is a continuation of the multicenter Polish study PREMATURITAS, was conducted, utilizing unique clinical data from 20 years ago. Objective The main goal was to evaluate lung function, detect any structural abnormalities using lung ultrasound, and assess psychological well-being in young adults born between 24 and 34 weeks of gestational age (GA). Additionally, the study aimed to investigate potential associations between perinatal risk factors and abnormalities observed in pulmonary function tests (PFTs) during adulthood. Methods The young survivors underwent a comprehensive set of PFTs, a lung ultrasound, along with the quality of life assessment. Information regarding the neonatal period and respiratory complications was obtained from the baseline data collected in the PREMATURITAS study. Results A total of 52 young adults, with a mean age of 21.6 years, underwent PFTs. They were divided into two groups based on GA: 24–28 weeks (n = 12) and 29–34 weeks (n = 40). The subgroup born more prematurely had significantly higher lung clearance index (LCI), compared to the other subgroup (p = 0.013). LCI ≥ 6.99 was more frequently observed in the more premature group (50% vs. 12.5%, p = 0.005), those who did not receive prenatal steroids (p = 0.020), with a diagnosis of Respiratory Distress Syndrome (p = 0.034), those who received surfactant (p = 0.026), and mechanically ventilated ≥ 7 days (p = 0.005). Additionally, elevated LCI was associated with the diagnosis of asthma (p = 0.010). Conclusions The findings suggest pulmonary effects due to prematurity persist into adulthood and their insult on small airway function. Regular follow-up evaluations of young survivors born preterm should include assessments of PFTs. Specifically, the use of LCI can provide valuable insights into long-term pulmonary impairment.

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Section: Discussionmentioning

confidence: 99%

Long-term pulmonary outcomes of young adults born prematurely: a Polish prospective cohort study PREMATURITAS 20

Walicka-Serzysko,

Postek,

Borawska-Kowalczyk

et al. 2024

BMC Pulm Med

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“…To our knowledge no previous meta-analysis has been published investigating FEV 1 /FVC in those born preterm across all gestational ages <37 weeks’ gestation. A recent systematic review and meta-analysis by D u B erry et al [ 116 ] investigated people born at moderate–late gestational ages (32 to <37 weeks’ gestation) reporting modest but significant overall decreases in FEV 1 /FVC in this group compared to those born at term. Our analysis extends these findings, to show that individuals born very (28–32 weeks’ gestation) and extremely (<28 weeks’ gestation) preterm have progressively more profound degrees of airway obstruction reported later in life, with those diagnosed with BPD as infants at the highest risk.…”

Section: Discussionmentioning

confidence: 99%

Increasing airway obstruction through life following bronchopulmonary dysplasia: a meta-analysis

et al. 2023

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Few studies exist investigating lung function trajectories of those born preterm, however growing evidence suggests some individuals experience increasing airway obstruction throughout life. Here we use the studies identified in a recent systematic review to provide the first meta-analysis investigating the impact of preterm birth on airway obstruction measured by the FEV1/FVC ratio.Cohorts were included for analysis if they reported FEV1/FVC in survivors of preterm birth (<37 weeks’ gestation) and control populations born at term. Meta-analysis was performed using a random effect model, expressed as standardised mean difference (SMD). Meta-regression was conducted using age and birth year as moderators.55 cohorts were eligible, 35 of which defined groups with bronchopulmonary dysplasia (BPD). Compared to control populations born at term, lower values of FEV1/FVC were seen in all individuals born preterm (SMD −0.56), with greater differences seen in those with BPD (SMD −0.87) than those without BPD (SMD −0.45). Meta-regression identified age as a significant predictor of FEV1/FVC in those with BPD with the FEV1/FVC ratio moving −0.04 SDs away from the term control population for every year of increased age.Survivors of preterm birth have significantly increased airway obstruction compared to those born at term with larger differences in those with BPD. Increased age is associated with a decline in FEV1/FVC values suggesting increased airway obstruction over the life course.

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“…Although the focus has naturally been on those patients deemed at highest risk, increasing evidence suggests that even mild degrees of prematurity confer additional risk to long‐term lung function 41 . Following this theme, poor somatic growth during early childhood also predicts impaired lung function in children assessed by forced oscillometry at age 4, as shown by Kaali et al 42 in a large Ghanaian cohort.…”

Section: Pulmonary Function Testing Outcomes Of Neonatal Diseasesmentioning

confidence: 94%

2022 Year in review: Neonatal pulmonology

Ryan

Auten

2023

Pediatric Pulmonology

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Long-term expiratory airflow of infants born moderate-late preterm: A systematic review and meta-analysis

Cited by 22 publications

References 51 publications

Long-term pulmonary outcomes of young adults born prematurely: a Polish prospective cohort study PREMATURITAS 20

Long-term pulmonary outcomes of young adults born prematurely: a Polish prospective cohort study PREMATURITAS 20

Increasing airway obstruction through life following bronchopulmonary dysplasia: a meta-analysis

2022 Year in review: Neonatal pulmonology

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