Cardiopulmonary Exercise Performance of Children Born Non-Extremely Preterm

Abstract

Data on exercise tolerance of children born non-extremely preterm are sparse. We aimed to explore the cardiopulmonary exercise testing (CPET) characteristics in this population. We studied 63 children (age 7-12 years) born at 29^0/7-36^6/7 weeks of gestation (34 were late preterm, 29 were preterm) and 63 age-matched, term-born controls. All performed spirometry and CPET (cycle ergometry). There were no differences in activity levels and spirometric parameters between the group of preterm-born children and controls. A peak oxygen uptake (VO₂peak) of <80% was noted in 25.4% of the term-born and 49.2% of preterm-born children (p = 0.001). Term-born participants presented similar VO₂peak to late-preterm children but higher than those born at <34^0/7 weeks of gestation (p = 0.002). Ventilatory limitation was noted in 4.8% of term and 7.9% of preterm participants, while only one preterm child presented cardiovascular limitation. Children born before 34 weeks of gestation had higher respiratory rates and smaller tidal volumes at maximum exercise, as well as lower oxygen uptake for the level of generated work. We conclude that school-age children born at 29-34 weeks of gestation may present decreased exercise performance attributed to an altered ventilatory response to exercise and impaired O₂ utilization by their skeletal muscles rather than other cardiopulmonary limiting factors.

Keywords: cardiopulmonary exercise testing; children; exercise performance; exercise tolerance; prematurity; preterm children.

Figure 1

Comparison of CPET parameters between term, late-preterm (GA 34^0/7–36^6/7 weeks), and preterm (GA 29^0/7–33^6/7 weeks) groups. Box and Whisker plots (mean, interquartile range, and range) including the raw data (dots). Statistical significance was assessed by Dunn’s multiple comparison test. Only p-values < 0.05 are presented.

Figure 2

Physical activity status and CPET-derived characteristics of the term and combined preterm group. The number of cases is presented within or alongside the bars. EIB: exercise-induced bronchoconstriction.