Lung function and respiratory outcomes in teenage boys and girls born very prematurely

Abstract

Objectives Male sex in prematurely born infants has been associated with worse respiratory outcomes in early childhood. Working Hypothesis Respiratory outcomes at 11 to 14 years of age in children born very prematurely and routinely exposed to antenatal corticosteroids and postnatal surfactant would differ according to sex. Study Design Analysis of follow‐up data. Patient‐Subject Selection Three hundred and nineteen children born before 29 weeks of gestational age from the United Kingdom Oscillation Study. Methodology Spirometry was used to assess forced expiratory flow at 75%, 50%, and 25% of expired vital capacity (FEF75, FEF50, and FEF25), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced vital capacity (FVC). Lung volumes were measured using a helium dilution technique (FRCHe) and by plethysmography (FRCpleth). Total lung capacity (TLC) and residual volume (RV) were calculated. Mean lung function measurements were compared using linear mixed models and reported as unadjusted and adjusted for neonatal and age 11 to 14 years factors. The participants also completed health questionnaires and provided a urine sample for assessment of passive or active smoking. Results Three (FEF25, FEF25‐75, FEV1) lung function measures showed significant differences in favor of females after adjustment. The percentage of children with abnormal lung function (below 5th centile for normal) had adjusted differences between 10 and 30 percentage points, for example, for FEF25 15% females compared with 26% males. Conclusions Among extremely prematurely born school children airway function was significantly worse in males.

Male Disadvantage in Oxidative Stress-Associated Complications of Prematurity: A Systematic Review, Meta-Analysis and Meta-Regression

“…The flow diagram of the search process is shown in Figure S1 . Of 1365 potentially relevant studies, 41 (including 625,680 infants, 319,470 males) were included [ 2 , 3 , 4 , 5 , 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. Their characteristics are summarized in Table S2 .…”

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

“…We have reported that lung function was impaired in males compared to girls born prematurely 39 . In this study, teenage boys were noted to have poorer FEV 1 , FEF 25 , and FEF 25–75 compared to teenage girls.…”

2020 year in review: Neonatal pulmonology

“…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.…”