Lung Function in Very Low Birth Weight Adults

Saarenpää, Heli-Kaisa; Tikanmäki, Marjaana; Sipola-Leppänen, Marika; Hovi, Petteri; Wehkalampi, Karoliina; Siltanen, Mirjami; Vääräsmäki, Marja; Järvenpää, Anna‐Liisa; Eriksson, Johan G.; Andersson, Sture; Kajantie, Eero

doi:10.1542/peds.2014-2651

Cited by 68 publications

(66 citation statements)

References 51 publications

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“…The association that we observed between birth weight and adult FVC supports Barker Gestational age is also a possible confounder, since prematurity is a strong predictor of birth weight and has been associated with lower lung function in adulthood (36)(37)(38). Disentangling the effects of birth weight and gestational age, however, is complex, as gestational age is highly correlated with birth weight and is also difficult to estimate reliably; the latter is particularly an issue for studies performed when early fetal ultrasound scans were less common.…”

Section: Discussionsupporting

confidence: 82%

Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis

et al. 2017

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At a Glance CommentaryScientific knowledge on the subject: Increasing evidence supports the influence of early life factors on later lung function, which might prevent individuals from attaining maximum lung function and predispose them to increased risk of lung disease in later life.What this study adds to the field: This is the first systematic review and meta-analysis on the association of birth weight, weight at one year and weight gain in the first year of life with lung function measures of both restrictive and obstructive patterns in adulthood. We convincingly show a positive association between birth weight and restrictive impairment (low FVC), with findings consistent across studies. The meta-analysis for birth weight and airflow obstruction (low FEV1/FVC) might suggest a positive association but the evidence is much weaker. We identified gaps and limitations in the current evidence that should be addressed in future research.This article has an online data supplement, which is accessible from this issue's table of content online at www.atsjournals.org. 3 AbstractRationale: There is evidence suggesting that birth weight may influence lung function in adulthood, but it is unclear whether it might differentially affect restrictive (FVC) and obstructive (FEV1/FVC) patterns.Objectives: To summarize evidence available on the association of birth weight, weight at one year and weight gain in the first year of life with FVC and FEV1/FVC in adulthood. Methods:We performed a systematic review of the literature by searching MEDLINE, EMBASE and Web of Science through January 2015. Data were combined using inversevariance weighted meta-analysis with random effects models, and between-study heterogeneity evaluated. We conducted a priori subgroup or sensitivity analyses by age, country wealth, ethnicity, sex and smoking. Risk of bias was evaluated using the Newcastle-Ottawa Scale, and reporting bias using funnel plots. Measurements and Main Results:Eighteen articles were included in the review, and 13 in the meta-analyses. Most studies were from high-income countries, and all showed low risk of bias.We found strong evidence of association of birth weight with adult FVC, a 59.4mL higher FVC in adulthood per kg increase in birth weight (95%CI: 43.3 to 75.5), with no evidence of heterogeneity. Evidence of an association of birth weight with FEV1/FVC was weaker and showed some inconsistency across studies. Only one study investigated weight at one year, and another one weight gain in the first year. Conclusions:Our meta-analyses show strong and consistent evidence of an association of birth weight with adult FVC, a measure of restrictive impairment, with much weaker evidence for airflow obstruction.

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Section: Discussionsupporting

confidence: 82%

Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis

et al. 2017

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“…16,17 Lower muscular fitness may partly be a consequence of previously observed lower physical activity levels among young adults born preterm, 6-8 which, in turn, could originate from poorer motor skills or reduced pulmonary function. 50 Our findings 3 emphasize the promotion of physical activity, in particular activity to enhance muscular fitness, across the whole range of preterm birth from early childhood onward. 51 A healthy lifestyle adopted in childhood is likely to carry on into adulthood.…”

Section: Discussionmentioning

confidence: 63%

Physical Fitness in Young Adults Born Preterm

et al. 2016

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“…While the parameters of the early inflammatory response (e.g. cytokines) may not be detectable after prolonged exposure to the above factors, the downstream signaling inflammatory/immune pathways have initiated and affected permanent structural and functional deficits in the BPD lungs, as well borne out by the same being noted in children and adult survivors of BPD 10– 13 . There is some clinical evidence that early interruption of the initial inflammatory response could result in the amelioration and potential reversal of these effects 14 .…”

Section: Pathogenesis Of Bronchopulmonary Dysplasiamentioning

confidence: 99%

How to decrease bronchopulmonary dysplasia in your neonatal intensive care unit today and “tomorrow”

Nelin

Bhandari

2017

F1000Res

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Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units.

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Lung Function in Very Low Birth Weight Adults

Cited by 68 publications

References 51 publications

Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis

Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis

Physical Fitness in Young Adults Born Preterm

How to decrease bronchopulmonary dysplasia in your neonatal intensive care unit today and “tomorrow”

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