Lung function and exercise capacity in prematurely born young people

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Objectives To assess if a previous diagnosis of bronchopulmonary dysplasia (BPD) was associated with poorer lung function at 16 to 19 years of age, regardless of whether postnatal corticosteroids had been administered. Working Hypothesis Infants with BPD will have poorer lung function at 16 to 19 years of age. Study Design Prospective follow‐up study. Patient‐Subject Selection One hundred and sixty‐one participants aged between 16 and 19 years who were born at less than 29 weeks of gestation; 87 had had BPD. Methodology Lung function was assessed by spirometry (FEV1, FVC, FEV1/FVC, FEF75, FEF50, FEF25, FEF25–75, PEF), impulse oscillometry (R5Hz and R20Hz), plethysmography (FRCpleth, TLCpleth, RVpleth), diffusion capacity of the lungs for carbon monoxide (DLCO, DLCO/VA) and lung clearance index (LCI). Questionnaires were used to quantify respiratory symptoms and a shuttle sprint test to assess exercise capacity. Results At 16 to 19 years, those who had had a diagnosis of BPD had poorer airway function (FEV1, FEF75, FEF50, FEF25–75) compared to those without. FVC and DLCO were also poorer in those who had BPD. Those differences remained significant after adjusting for sex, gestational age, and maternal smoking. When excluding those who had received postnatal corticosteroids, differences remained significant in FEV1, FVC, and FEF75. There were no significant differences in exercise capacity or respiratory symptoms between those with and without BPD. Conclusions In adolescents and young adults born prematurely, those who had BPD had poorer lung function compared to those without, regardless of whether they had received postnatal corticosteroids.

Section: Methodsmentioning

confidence: 99%

Influence of bronchopulmonary dysplasia on lung function in adolescents who were born extremely prematurely

Harris

Morris

Lunt

et al. 2022

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“…Former ELBW subjects had higher rates of impairments in pulmonary function in adolescence than term controls, with severe impairments being more common in boys (26%) than girls (15%). Exercise capacity, as would be expected, is also diminished 19,20 . Even well‐intentioned exposures such as antenatal corticosteroids to prevent complications of premature birth may have at least short‐term adverse effects.…”

Section: Outcomes From Neonatal Lung Conditionsmentioning

confidence: 85%

“…Exercise capacity, as would be expected, is also diminished. 19,20 Even well-intentioned exposures such as antenatal corticosteroids to prevent complications of premature birth may have at least short-term adverse effects. Among children born at term gestation, but whose mothers were treated previously with corticosteroids for threatened preterm delivery, FVC and FEV 0.5 were diminished at age ~7 months.…”

Section: Outcomes From Neonatal Lung Conditionsmentioning

confidence: 99%

2020 year in review: Neonatal pulmonology

Auten

Ryan

2021

“…Where appropriate, lung function scores were converted to Z‐scores based on height, sex and age 25–28 . Exercise capacity was assessed by a modified shuttle sprint test, 29 the outcome was the distance traveled until completion of the test 30 . Individuals were asked to travel between two cones 10 m apart in time with audible tones, where the time between tones became incrementally shorter each minute.…”

Section: Methodsmentioning

confidence: 99%

Intrauterine growth retardation and lung function of very prematurely born young people

Harris

Lunt

Bisquera

et al. 2021

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Objectives To assess if intrauterine growth retardation (IUGR) was associated with reduced lung function at 16–19 years. Working Hypothesis Very prematurely born young people who had IUGR would have reduced lung function postpuberty. Study Design Prospective follow‐up study. Patient‐subject Selection One hundred and fifty‐nine 16–19 year olds born before 29 weeks of gestation; 37 had IUGR. Methodology Lung function tests were performed: spirometry was used to assess forced expiratory volume in one second (FEV1), forced expiratory flow at 75%, 50% and 25% of expired vital capacity (FEF75, FEF50 and FEF25), peak expiratory flow (PEF) and forced vital capacity (FVC). Functional residual capacity (FRCpleth) total lung capacity (TLCpleth) and residual volume (RVpleth) were measured. Alveolar function was assessed by diffusion capacity within the lungs of carbon monoxide (DLCO). Impulse oscillometry was used to assess respiratory resistance and lung clearance index to assess ventilation homogeneity. Exercise capacity was assessed using a shuttle sprint test. Results After adjustment for BMI, the mean FEV1/FVC, FEF75, FEF25‐75, FRCpleth and RVpleth were poorer in those who had had IUGR, with differences between 0.56 and 0.75 z‐scores. After further adjustment for BPD and postnatal corticosteroid use, only the difference in RVpleth z‐scores remained statistically significant, adjusted difference (95% CI): 0.66 (0.18,1.13). Exercise capacity was lower in those with IUGR and this was more pronounced in males (p=0.04). Conclusions At 16–19 years of age, those who had IUGR had poorer lung function and exercise capacity compared with those with adequate intrauterine growth.