Vollsæter Maria, Clemm Hege H, Satrell Emma, Eide Geir E, Røksund Ola D, Markestad Trond, Halvorsen Thomas
1 Department of Clinical Science, Section for Pediatrics, University of Bergen, Bergen, Norway.
Ann Am Thorac Soc. 2015 Mar;12(3):313-22. doi: 10.1513/AnnalsATS.201406-285OC.
Lifetime respiratory function after extremely preterm birth (gestational age≤28 wk or birth weight≤1,000 g) is unknown.
To compare changes from 18-25 years of age in respiratory health, lung function, and airway responsiveness in young adults born extremely prematurely to that of term-born control subjects.
Comprehensive lung function investigations and interviews were conducted in a population-based sample of 25-year-old subjects born extremely prematurely in western Norway in 1982-1985, and in matched term-born control subjects. Comparison was made to similar data collected at 18 years of age.
At 25 years of age, 46/51 (90%) eligible subjects born extremely prematurely and 39/46 (85%) control subjects participated. z-Scores for FEV1, forced expiratory flow at 25-75% of vital capacity, and FEV1/FVC were significantly reduced in subjects born extremely prematurely by 1.02, 1.26, and 0.88, respectively, and airway resistance (kPa/L/s) was increased (0.23 versus 0.18). Residual volume to total lung capacity increased with severity of neonatal bronchopulmonary dysplasia. Responsiveness to methacholine (dose-response slope; 3.16 versus 0.85) and bronchial lability index (7.5 versus 4.8%) were increased in subjects born extremely prematurely. Lung function changes from 18 to 25 years and respiratory symptoms were similar in the prematurely born and term-born groups.
Lung function in early adult life was in the normal range in the majority of subjects born extremely prematurely, but methacholine responsiveness was more pronounced than in term-born young adults, suggesting a need for ongoing pulmonary monitoring in this population.
极早产儿（胎龄≤28周或出生体重≤1000克）的终生呼吸功能尚不清楚。
比较极早产儿与足月儿对照人群在18至25岁时呼吸健康、肺功能和气道反应性的变化。
对1982 - 1985年在挪威西部出生的极早产25岁人群样本以及匹配的足月儿对照人群进行全面的肺功能检查和访谈。并与18岁时收集的类似数据进行比较。
25岁时，51名符合条件的极早产儿中有46名（90%）参与，46名对照人群中有39名（85%）参与。极早产儿的第一秒用力呼气容积（FEV1）、肺活量25%-75%时的用力呼气流量以及FEV1/用力肺活量（FVC）的z评分分别显著降低1.02、1.26和0.88，气道阻力（kPa/L/s）增加（0.23对0.18）。残气量与肺总量的比值随新生儿支气管肺发育不良的严重程度增加。极早产儿对乙酰甲胆碱的反应性（剂量反应斜率；3.16对0.85）和支气管易激指数（7.5%对4.8%）增加。极早产组和足月儿组从18岁到25岁的肺功能变化和呼吸道症状相似。
大多数极早产儿在成年早期的肺功能处于正常范围，但对乙酰甲胆碱的反应性比足月儿更明显；这表明该人群需要持续的肺部监测。
