Airway obstruction in young adults born extremely preterm or extremely low birth weight in the postsurfactant era.


Journal

Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353

Informations de publication

Date de publication:
12 2019
Historique:
received: 27 06 2019
revised: 05 08 2019
accepted: 30 08 2019
pubmed: 29 9 2019
medline: 27 5 2020
entrez: 28 9 2019
Statut: ppublish

Résumé

It is unknown if adults born <28 weeks or <1000 g since surfactant has been available are reaching their full airway growth potential. To compare expiratory airflow at 25 years and from 8 to 25 years of participants born <28 weeks or <1000 g with controls, and within the preterm group to compare those who had bronchopulmonary dysplasia with those who did not. All survivors born <28 weeks or <1000 g in 1991-1992 in Victoria, Australia, were eligible. Controls were born contemporaneously, weighing >2499 g. At 8, 18 and 25 years, expiratory airflows were measured and the results converted to z-scores. Outcomes were compared between groups at age 25 years, and trajectories (change in z-scores per year) from childhood were contrasted between groups. Expiratory airflows were measured at 25 years on 164 of 297 (55%) preterm survivors and 130 of 260 (50%) controls. Preterm participants had substantially reduced airflow compared with controls at age 25 years (eg, zFEV Young adults born <28 weeks or <1000 g in the surfactant era, particularly those who had bronchopulmonary dysplasia, have substantially reduced airway function compared with controls. Some are destined to develop COPD in later adult life.

Sections du résumé

BACKGROUND
It is unknown if adults born <28 weeks or <1000 g since surfactant has been available are reaching their full airway growth potential.
OBJECTIVE
To compare expiratory airflow at 25 years and from 8 to 25 years of participants born <28 weeks or <1000 g with controls, and within the preterm group to compare those who had bronchopulmonary dysplasia with those who did not.
METHODS
All survivors born <28 weeks or <1000 g in 1991-1992 in Victoria, Australia, were eligible. Controls were born contemporaneously, weighing >2499 g. At 8, 18 and 25 years, expiratory airflows were measured and the results converted to z-scores. Outcomes were compared between groups at age 25 years, and trajectories (change in z-scores per year) from childhood were contrasted between groups.
RESULTS
Expiratory airflows were measured at 25 years on 164 of 297 (55%) preterm survivors and 130 of 260 (50%) controls. Preterm participants had substantially reduced airflow compared with controls at age 25 years (eg, zFEV
CONCLUSIONS
Young adults born <28 weeks or <1000 g in the surfactant era, particularly those who had bronchopulmonary dysplasia, have substantially reduced airway function compared with controls. Some are destined to develop COPD in later adult life.

Identifiants

pubmed: 31558625
pii: thoraxjnl-2019-213757
doi: 10.1136/thoraxjnl-2019-213757
doi:

Substances chimiques

Pulmonary Surfactants 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1147-1153

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Lex William Doyle (LW)

Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia lwd@unimelb.edu.au.
Newborn Services, The Royal Women's Hospital, Parkville, Victoria, Australia.
Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Louis Irving (L)

Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Anjali Haikerwal (A)

Newborn Services, The Royal Women's Hospital, Parkville, Victoria, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Katherine Lee (K)

Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Sarath Ranganathan (S)

Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
Respiratory DIseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Jeanie Cheong (J)

Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
Newborn Services, The Royal Women's Hospital, Parkville, Victoria, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

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