Relationship between infant lung mechanics and childhood lung function in children of very low birthweight

Abstract

Twenty-seven children of very low birthweight (less than or equal to 1,500 g) whose lung function had been measured on several occasions during the first year were studied at the age of about 9 years. Fifteen of the children had received neonatal intermittent positive pressure ventilation, mostly for respiratory distress syndrome. Ten of the ventilated children were still oxygen dependent at 30 days of age. Compared to the remainder of the group, mechanically ventilated children had reduced lung compliance in early infancy and increased thoracic gas volume in the middle of their first year. These changes correlated with the level of neonatal respiratory therapy as indicated by the oxygen score. Lung compliance in early infancy, but not thoracic gas volume, correlated with forced expiratory volume at 1 second recorded at 9 years. On the other hand, reduced airway conductance showed no significant correlation with the neonatal oxygen score, but there was a strong correlation between airway conductance late in infancy and lung function at 9 years. This relationship was independent of neonatal mechanical ventilation. We conclude that perinatal factors, which may be associated with disturbed lung mechanics early in infancy, are only weak and indirect predictors of childhood lung function. Airway conductance late in infancy, determined by constitutional factors, prematurity itself or other undetermined factors, is a good predictor of airway function at 9 years.