Respiratory outcomes of “new” bronchopulmonary dysplasia in adolescents: A multicenter study

Abstract

Objective Long‐term respiratory consequences of bronchopulmonary dysplasia (BPD) in preterm infants born in the post‐surfactant era (“new” BPD) remain partially unknown. The present study aimed to evaluate the respiratory outcomes of “new” BPD in adolescents who were born preterm. Methods This multicenter, cross‐sectional study included 286 adolescents born between 2003 and 2005 (mean age: 14.2 years); among them, 184 and 102 were born extremely preterm (EP; <28 weeks' gestation) and moderate–late preterm (32 to <37 weeks' gestation), respectively. Among EP adolescents, 92 had BPD, and 92 did not. All participants underwent lung function tests, skin prick testing, and questionnaires on asthma symptoms and quality of life. Results EP adolescents with BPD had significantly lower forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow between 25% and 75% of FVC than other included adolescents. FEV1/FVC ratios were below the lower limit of normal (z‐score <−1.645) in 30.4% of EP adolescents with BPD, 13.0% of EP adolescents without BPD, and 11.8% of adolescents who were born moderate–late preterm. Bronchodilator response and air‐trapping were significantly higher in BPD adolescents than in other adolescents. Diffusion capacity was significantly lower in EP adolescents than in moderate–late preterm adolescents. Asthma symptoms and quality‐of‐life scores were similar among groups. Conclusion EP adolescents with “new” BPD had poorer pulmonary function than EP adolescents without BPD or moderate–late preterm adolescents. Further studies are needed to determine whether “new” BPD is associated with early‐onset chronic obstructive pulmonary disease in adulthood.

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

“…Once the responses from contacted study authors were collated, 18 articles satisfied the inclusion criteria. 14 , 15 , 16 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 15 studies reported expiratory airflow data from MLP participants, 14 , 15 , 16 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 eight of which compared MLP participants with term-born controls. 14 , 15 , 16 , 37 , 38 , 39 , 40 , 41 , 42 Three studies were not eligible for meta-analysis, with two unable to provide z-score data, 29 , 30 and one with indices of impulse oscillometry only.…”

“… 14 , 15 , 16 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 Study Region MLP Birth Characteristics Sex (% Male) Assessment Gestational Age (wk) Birthweight (g) MLP Term MLP Age (years) No. of Participants Pulmonary Function Tests Conducted Spirometry Reference Values Mean SD Range Mean SD Mean SD Range MLP Term Aoyama et al, 2021 31 a USA 33.9 1.3 2189 592 72 NA 7.3 1.8 7 NA Spirometry GLI 2012 Arroyas et al, 2020 36 Spain 34.2 1.2 2014 526 51.4 NA 14.1 74 NA ...…”

Steroid use for established bronchopulmonary dysplasia: study protocol for a systematic review and meta-analysis

“…BPD is also burdened by long-term consequences, which include impaired lung function and architecture, recurrent respiratory infections and poor neurodevelopmental outcomes. Respiratory difficulties may continue well into adolescence and adulthood 9–12. Mortality rate is up to 3% during first admission in infants diagnosed with severe BPD and 20% within 2 years of life in infants requiring tracheostomy 13–15…”

Steroid Use for Established Bronchopulmonary Dysplasia: Study Protocol for a Systematic Review and Meta-analysis.

“…BPD is also burdened by long-term consequences, which include impaired lung function and architecture, recurrent respiratory infections, and poor neurodevelopmental outcomes. Respiratory di culties may continue well into adolescence and adulthood (9)(10)(11)(12).…”