Pulmonary function and respiratory morbidity in school‐age children born prematurely and ventilated for neonatal respiratory insufficiency

Abstract

We examined 72 children aged 6-9 years to assess the effects of prematurity and ventilator treatment on subsequent lung function and respiratory morbidity. The preterm study group (n = 42) was divided into children with a history of bronchopulmonary dysplasia (BPD) (n = 10), children who had had neonatal respiratory treatment but no BPD (n = 19), and children without severe neonatal respiratory problems (n = 13). The BPD children as a group had markedly lower specific airway conductance and larger residual volume than did the full-term control group, but there were no significant differences in spirometric measurements. The BPD group also had higher respiratory morbidity requiring hospitalizations, particularly during the first 2 years of life, than did the children in the other study groups. Therefore, BPD may improve but does not disappear as age increases. Non-BPD children who had had ventilator treatment as neonates recovered well and suffered no severe respiratory problems after infancy. Pulmonary function parameters in prematurely born children without neonatal ventilator treatment did not differ from those in the full-term control group. Thus, neonatal lung disease seems to be a more important determinant of abnormal pulmonary function at a later age than is prematurity alone.

Effects of intrauterine growth retardation and prematurity on spirometric flow values and lung volumes at school age in twin pairs

“…Maximum mid-expiratory flow FEF 75 Forced expiratory flow at 25% of the maximal VC FEV 1 Forced expiratory volume in one second FEV 1 2 Homogenous reticulogranular pattern in chest X-ray and need for oxygen in premature infants. 3 Need for supplemental oxygen at 36 weeks of corrected postnatal gestational age. 5 4 IUGR, intrauterine growth retardation; AGA, appropriate for gestational age.…”

“…2 In prematurely born children who did not require mechanical ventilation, pulmonary expiratory flow values and lung volumes did not differ from values of full-term healthy control children. 3 On the other hand, reduced fetal growth in both preterm and full-term infants was significantly associated with both poor expiratory flow values (except FEF ) and reduced lung volumes. 4 The present study was designed to quantify the separate effects of prematurity and intrauterine growth retardation (IUGR) on lung volumes and airway flow values.…”

Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia

“…Again, variable definitions of BPD were used. The majority of studies (n = 26) used case-control study design (18,19,22,23,25,28,29,32,34,35,37,39,41,42,44,45,54,56,59,62,63,66,67,70,71,75), and the remaining used either retrospective (n = 4) or prospective (n = 4) cohort study designs (20,24,36,43,49,52,57,60).…”

Pulmonary function at school-age in surfactant-treated preterm infants

“…20,22,[29][30][31] As has been postulated from studies in infancy and early childhood, 9,10 there is no adverse effect of early surfactant treatment; nor does it improve pulmonary outcome in the long term.…”

“…Respiratory morbidity in childhood depends on the severity of respiratory disease during the neonatal period. 20 In the study of Couser et al, 10 there was a high prevalence of BPD as defined by oxygen dependency on day 28, and this may result in impaired lung function up to at least age 2 years. 21 However, most of the BPD cases in our study population were mild to moderate, which may explain the normal findings in most of our patients.…”