Nottingham Respiratory Research Unit, School of Medicine, University of Nottingham, City Hospital Campus, Nottingham, UK Department of Respiratory Medicine, Nottingham University Hospitals Trust, Nottingham, UK.
Department of Paediatric Respirology, National Heart and Lung Institute, Imperial College, London, UK Department of Paediatric Respiratory Medicine, Royal Brompton Harefield NHS Foundation Trust, London, UK.
Thorax. 2015 Jun;70(6):574-80. doi: 10.1136/thoraxjnl-2014-206590. Epub 2015 Mar 30.
Although survival has improved significantly in recent years, prematurity remains a major cause of infant and childhood mortality and morbidity. Preterm births (<37 weeks of gestation) account for 8% of live births representing >50 000 live births each year in the UK. Preterm birth, irrespective of whether babies require neonatal intensive care, is associated with increased respiratory symptoms, partially reversible airflow obstruction and abnormal thoracic imaging in childhood and in young adulthood compared with those born at term. Having failed to reach their optimal peak lung function in early adulthood, there are as yet unsubstantiated concerns of accelerated lung function decline especially if exposed to noxious substances leading to chronic respiratory illness; even if the rate of decline in lung function is normal, the threshold for respiratory symptoms will be crossed early. Few adult respiratory physicians enquire about the neonatal period in their clinical practice. The management of these subjects in adulthood is largely evidence free. They are often labelled as asthmatic although the underlying mechanisms are likely to be very different. Smoking cessation, maintaining physical fitness, annual influenza immunisation and a general healthy lifestyle should be endorsed irrespective of any symptoms. There are a number of clinical and research priorities to maximise the quality of life and lung health in the longer term not least understanding the underlying mechanisms and optimising treatment, rather than extrapolating from other airway diseases.
尽管近年来生存率有了显著提高，但早产仍是导致婴儿和儿童死亡和发病的主要原因。早产儿（<37 周妊娠）占活产儿的 8%，每年在英国超过 50000 例。与足月出生的婴儿相比，无论早产儿是否需要新生儿重症监护，他们在儿童期和青年期更易出现呼吸症状、部分可逆性气流阻塞和异常的胸部影像学改变。由于未能在成年早期达到最佳的峰值肺功能，人们担心如果接触有害物质导致慢性呼吸道疾病，肺功能会加速下降，尽管肺功能下降的速度正常，但呼吸症状的阈值会提前出现。在临床实践中，很少有成年呼吸科医生询问新生儿期的情况。这些患者在成年期的管理主要缺乏证据。他们通常被贴上哮喘的标签，尽管潜在的机制可能大不相同。无论是否有任何症状，都应提倡戒烟、保持身体健康、每年接种流感疫苗和保持健康的生活方式。为了最大限度地提高生活质量和长期的肺部健康，有许多临床和研究重点，尤其是了解潜在机制和优化治疗，而不是从其他气道疾病推断。
