Predicting Lung Health Trajectories for Survivors of Preterm Birth

Abstract

Rates of preterm birth (<37 weeks of gestation) are increasing worldwide. Improved perinatal care has markedly increased survival of very (<32 weeks gestation) and extremely (<28 weeks gestation) preterm infants, however, long term respiratory sequalae are common among survivors. Importantly, individual's lung function trajectories are determined early in life and tend to track over the life course. Preterm infants are impacted by antenatal, postnatal and early life perturbations to normal lung growth and development, potentially resulting in significant shifts from the "normal" lung function trajectory. This review summarizes what is currently known about the long-term lung function trajectories in survivors of preterm birth. Further, this review highlights how antenatal, perinatal and early life factors are likely to contribute to individual lung health trajectories across the life course.

Keywords: bronchopulmonary dysplasia; infant; lung function; lung function trajectory; preterm.

Figure 1

Outline of potential lung function trajectories and lung function perturbations throughout life: normal (green), persistently reduced lung function (orange), and early decline in lung function with increased obstruction during growth (red), with a potential for accelerated physiological aging in adulthood. Potential insults to lung health and their possible impact on lung function throughout life marked. Also noted is a potential for “catch up” growth to normal lung function which may occur during childhood and adolescence.