Telethon Kids Institute, Perth, Australia; School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia.
Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK.
Paediatr Respir Rev. 2018 Sep;28:87-94. doi: 10.1016/j.prrv.2018.04.001. Epub 2018 Apr 13.
Preterm birth accounts for approximately 11% of births globally, with rates increasing across many countries. Concurrent advances in neonatal care have led to increased survival of infants of lower gestational age (GA). However, infants born <32 weeks of GA experience adverse respiratory outcomes, manifesting with increased respiratory symptoms, hospitalisation and health care utilisation into early childhood. The development of bronchopulmonary dysplasia (BPD) - the chronic lung disease of prematurity - further increases the risk of poor respiratory outcomes throughout childhood, into adolescence and adulthood. Indeed, survivors of preterm birth have shown increased respiratory symptoms, altered lung structure, persistent and even declining lung function throughout childhood. The mechanisms behind this persistent and sometimes progressive lung disease are unclear, and the implications place those born preterm at increased risk of respiratory morbidity into adulthood. This review aims to summarise what is known about the long-term pulmonary outcomes of contemporary preterm birth, examine the possible mechanisms of long-term respiratory morbidity in those born preterm and discuss addressing the unknowns and potentials for targeted treatments.
早产占全球分娩的大约 11%，许多国家的早产率都在上升。新生儿护理的同步进步导致较低胎龄 (GA) 的婴儿存活率增加。然而，GA<32 周出生的婴儿会出现不良的呼吸结局，表现为呼吸症状增加、住院和医疗保健利用增加到幼儿期。支气管肺发育不良 (BPD) - 早产儿的慢性肺部疾病 - 进一步增加了整个儿童期、青春期和成年期不良呼吸结局的风险。事实上，早产儿幸存者表现出呼吸症状增加、肺结构改变、持续性甚至逐渐下降的肺功能。这种持续性甚至有时进展性肺部疾病的机制尚不清楚，这意味着那些早产儿在成年后患呼吸道疾病的风险增加。本综述旨在总结目前对当代早产儿长期肺部结局的了解，检查早产儿长期呼吸发病率的可能机制，并讨论解决未知问题和有针对性治疗的潜力。
