Longitudinal assessment of lung function in extremely prematurely born children.

OBJECTIVES

To assess longitudinally small airway function in children born extremely prematurely and whether there was a correlation between airway function in infancy and at 11-14 years.

WORKING HYPOTHESES

There would be tracking of airways obstruction and small airway function would deteriorate during childhood in those born extremely prematurely.

STUDY DESIGN

A longitudinal study.

PATIENT-SUBJECT SELECTION: Thirty-five children with a mean gestational age of 26 weeks had lung function assessed at 1 year corrected and 11-14 years of age.

METHODOLOGY

Lung volumes were measured by helium gas dilution (FRC ) and plethysmography (FRC ) and small airway function assessed by calculating the FRC :FRC ratio. Airway function was assessed at 1 year corrected by measurement of airway resistance (R ) and at 11-14 years by assessment of R , forced expiratory flow from 75% of vital capacity (FEF ), and forced expiratory volume at one second (FEV ).

RESULTS

At the first assessment, the children had a mean (SD) FRC :FRC of 0.90 (0.13) and at the second, 0.83 (0.12) (P = 0.035). There was a significant 0.54% decrease (95%CI: -1.02%, -0.06%) in FRC :FRC for increased age per year after adjusting for birth weight, gestational age, sex, and bronchopulmonary dysplasia (P = 0.027). There were significant correlations between R at the first assessment and R (P = 0.012), FEF (P = 0.034), and FEV (P = 0.04) at 11-14 years.

CONCLUSIONS

These results demonstrate in those born extremely prematurely there is tracking of airway function during childhood.