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社区为基础队列中中度晚期早产儿青少年的呼吸健康。

Respiratory Health in Adolescents Born Moderately-Late Preterm in a Community-Based Cohort.

机构信息

Department of Pediatrics, Pediatric Pulmonology, Beatrix Children's Hospital Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

J Pediatr. 2018 Dec;203:429-436. doi: 10.1016/j.jpeds.2018.07.083. Epub 2018 Sep 25.

Abstract

OBJECTIVES

To determine the long-term effects of moderately-late preterm (MLP) birth on respiratory and allergic symptoms, lung function, and exercise capacity in adolescence.

STUDY DESIGN

Outcome variables in this prospective cohort were prevalence of symptoms determined by International Study of Asthma and Allergies in Childhood questionnaires, lung function, and exercise measures.

RESULTS

Response rate was 47% and did not vary importantly by background characteristics. In total, 71 children (aged 13-14 years) participated in the measurements, 37 born MLP and 34 born full term. Both groups were comparable in height, weight, and exercise activities but differed in gestational age (MLP 34 ± 1 weeks, full term 39 ± 0.9 weeks) and birth weight (MLP 2442 ± 539 g, full term 3693 ± 393 g). Adolescents born MLP reported more (dry) cough (MLP 25% vs those born full term 3%, P = .016) and hay fever (MLP 34% vs those born full term 9%, P = .015). Adolescents born MLP did not report more wheeze, dyspnea, asthma, and eczema. Most lung function measurements were within the normal range for both groups, except peak expiratory flow (MLP 86% of predicted vs those born full term 93%, P = .05) and maximum expiratory flow when 75% of the forced vital capacity has been exhaled (MLP 86% predicted vs those born full term 96% predicted, P = .06), which were at the lower limit of normal. We observed no differences between the groups in exercise parameters.

CONCLUSION

Moderately late preterm birth has little effect on respiratory health in adolescence. Adolescents born MLP report few symptoms, have only slightly more lung function abnormalities than those born full term, and do not differ in the maximal exercise test and in physical activity level.

TRIAL REGISTRATION

ISRCTN 80622320.

摘要

目的

确定中度晚期早产儿(MLP)出生对青少年时期呼吸道和过敏症状、肺功能和运动能力的长期影响。

研究设计

本前瞻性队列研究的结局变量由儿童哮喘和过敏国际研究问卷调查确定,包括症状流行率、肺功能和运动测量。

结果

应答率为 47%,且不受背景特征的重要影响。共有 71 名儿童(年龄 13-14 岁)参与了测量,其中 37 名出生于 MLP,34 名出生于足月。两组在身高、体重和运动活动方面相当,但在胎龄(MLP 34±1 周,足月 39±0.9 周)和出生体重(MLP 2442±539 g,足月 3693±393 g)方面存在差异。出生于 MLP 的青少年报告更多(干咳)(MLP 25%比足月出生的儿童 3%,P=0.016)和花粉热(MLP 34%比足月出生的儿童 9%,P=0.015)。出生于 MLP 的青少年报告的喘息、呼吸困难、哮喘和湿疹并不多。两组的大多数肺功能测量值均在正常范围内,除了呼气峰流速(MLP 为预计值的 86%,而足月出生的儿童为 93%,P=0.05)和呼出 75%用力肺活量时的最大呼气流量(MLP 为预计值的 86%,而足月出生的儿童为预计值的 96%,P=0.06),这些都接近正常范围的下限。我们没有观察到两组之间在运动参数方面存在差异。

结论

中度晚期早产儿出生对青少年时期的呼吸道健康几乎没有影响。出生于 MLP 的青少年报告的症状很少,肺功能异常略多于足月出生的儿童,最大运动试验和体力活动水平没有差异。

试验注册

ISRCTN 80622320。

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