Pulmonary outcome in former preterm, very low birth weight children with bronchopulmonary dysplasia: a case-control follow-up at school age

Abstract

Objective: To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era.

Study design: Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire.

Results: At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group.

Conclusion: Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD.

Keywords: ATS; Airway resistance; American Thoracic Society; BPD; Bronchopulmonary dysplasia; DL(CO); ERS; European Respiratory Society; FEF(25)/FEF(50)/FEF(75); FEF(25-75); FEV(1); FVC; Forced expiratory flow rate at 25%/50%/75% of forced vital capacity; Forced expiratory flow rate between 25% and 75% of expired forced vital capacity; Forced expiratory volume in 1 second; Forced vital capacity; PMA; Postmenstrual age; R(AW); RV; Residual volume; TLC; Total lung capacity; Transfer factor of carbon monoxide; VLBW; Very low birth weight.