Department of Clinical Science, Section for Pediatrics, University of Bergen, Bergen, Norway.
Thorax. 2013 Aug;68(8):767-76. doi: 10.1136/thoraxjnl-2012-202980. Epub 2013 Jun 7.
As a result of advances in perinatal care, more small preterm infants survive. There are concerns that preterm birth and its treatments may harm pulmonary development and thereby lead to chronic airway obstruction in adulthood.
To assess the development of spirometric lung function variables from mid-childhood to adulthood after extreme preterm birth.
Two population-based cohorts born at gestational age ≤28 weeks or with birth weight ≤1000 g performed lung function tests at 10 and 18 and at 18 and 25 years of age, respectively, together with matched term-born controls. The results are presented as z scores, normalised for age, sex and height. Longitudinal development was compared for groups born at term and preterm, split by a history of absence (n=20), mild (n=38) or moderate/severe (n=25) neonatal bronchopulmonary dysplasia (BPD).
The preterm-born cohorts, particularly those with neonatal BPD, had significantly lower forced expiratory volume in 1 s and mid-expiratory flow than those born at term at all assessments (z scores in the range -0.40 to -1.84). Within each of the subgroups the mean z scores obtained over the study period were largely similar, coefficients of determination ranging from 0.64 to 0.82. The pattern of development for the BPD subgroups did not differ from each other or from the groups born at term (tests of interaction).
Airway obstruction was present from mid-childhood to adulthood after extreme preterm birth, most evident after neonatal BPD. Lung function indices were tracking similarly in the preterm and term-born groups.
由于围产期护理的进步，更多的小早产儿存活下来。人们担心早产及其治疗可能会损害肺部发育，从而导致成年后慢性气道阻塞。
评估极早早产儿从儿童中期到成年期的肺功能指标的发展。
两个基于人群的队列，出生胎龄≤28 周或出生体重≤1000g，分别在 10 岁、18 岁和 18 岁、25 岁时进行肺功能检查，并与足月出生的对照组相匹配。结果以 z 分数表示，按年龄、性别和身高进行标准化。分别比较了足月和早产出生的两组，根据有无（n=20）、轻度（n=38）或中重度（n=25）新生儿支气管肺发育不良（BPD）的病史进行分组。
早产儿队列，尤其是有新生儿 BPD 的早产儿，在所有评估中用力呼气量 1 秒（FEV1）和呼气中期流量均显著低于足月出生的婴儿（z 分数范围为-0.40 至-1.84）。在每个亚组中，研究期间获得的平均 z 分数大致相似，决定系数范围为 0.64 至 0.82。BPD 亚组的发展模式彼此之间以及与足月出生的婴儿（交互检验）没有差异。
极早早产儿从儿童中期到成年期都存在气道阻塞，在新生儿 BPD 后最为明显。肺功能指标在早产儿和足月出生的婴儿中呈相似的发展趋势。
