University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
Abteilung für Kinder- und Jugendmedizin, Klinikum Mutterhaus der Borromäerinnen, Feldstr. 16, 54290, Trier, Germany.
Respir Res. 2019 Nov 21;20(1):260. doi: 10.1186/s12931-019-1238-0.
Extreme prematurity has been associated with exercise intolerance and reduced physical activity. We hypothesized that children with bronchopulmonary dysplasia (BPD) would be especially affected based on long-term lung function impairments. Therefore, the objective of this study was to compare exercise capacity and habitual physical activity between children born very and extremely preterm with and without BPD and term-born children.
Twenty-two school-aged children (aged 8 to 12 years) born with a gestational age < 32 weeks and a birthweight < 1500 g (9 with moderate or severe BPD (=BPD), 13 without BPD (=No-BPD)) and 15 healthy term-born children (=CONTROL) were included in the study. Physical activity was measured by accelerometry, lung function by spirometry and exercise capacity by an incremental cardiopulmonary exercise test.
Peak oxygen uptake was reduced in the BPD-group (83 ± 11%predicted) compared to the No-BPD group (91 ± 8%predicted) and the CONTROL group (94 ± 9%predicted). In a general linear model, variance of peak oxygen uptake was significantly explained by BPD status and height but not by prematurity (p < 0.001). Compared to CONTROL, all children born preterm spent significantly more time in sedentary behaviour (BPD 478 ± 50 min, No-BPD 450 ± 52 min, CONTROL 398 ± 56 min, p < 0.05) and less time in moderate-to-vigorous-physical activity (BPD 13 ± 8 min, No-BPD 16 ± 8 min, CONTROL 33 ± 16 min, p < 0.001). Prematurity but not BPD contributed significantly to explained variance in a general linear model of sedentary behaviour and likewise moderate-to-vigorous-physical activity (p < 0.05 and p < 0.001 respectively).
In our cohort, BPD but not prematurity was associated with a reduced exercise capacity at school-age. However, prematurity regardless of BPD was related to less engagement in physical activity and more time spent in sedentary behaviour. Thus, our findings suggest diverging effects of prematurity and BPD on exercise capacity and physical activity.
极早产与运动不耐受和体力活动减少有关。我们假设支气管肺发育不良（BPD）患儿会受到影响，这是基于长期肺功能损害。因此，本研究的目的是比较患有和不患有 BPD 的极早产儿和极早产儿与足月出生儿童的运动能力和习惯性体力活动。
本研究纳入了 22 名 8 至 12 岁的在校儿童（胎龄<32 周，出生体重<1500g），其中 9 名患有中重度 BPD（=BPD），13 名无 BPD（=无 BPD），15 名健康足月出生的儿童（=对照组）。通过加速度计测量体力活动，通过肺活量计测量肺功能，通过递增心肺运动试验测量运动能力。
与无 BPD 组（91±8%预测值）和对照组（94±9%预测值）相比，BPD 组的峰值摄氧量降低（83±11%预测值）。在一般线性模型中，峰值摄氧量的方差显著受 BPD 状态和身高解释，但不受早产的影响（p<0.001）。与对照组相比，所有早产儿的久坐行为时间明显更长（BPD 组 478±50 分钟，无 BPD 组 450±52 分钟，对照组 398±56 分钟，p<0.05），中高强度体力活动时间明显更短（BPD 组 13±8 分钟，无 BPD 组 16±8 分钟，对照组 33±16 分钟，p<0.001）。一般线性模型中，早产而不是 BPD 显著解释了久坐行为和中高强度体力活动的方差（p<0.05 和 p<0.001）。
在本队列中，BPD 而非早产与学龄期运动能力下降有关。然而，无论是否患有 BPD，早产都与体力活动参与度较低和久坐时间较长有关。因此，我们的研究结果表明，早产和 BPD 对运动能力和体力活动的影响存在差异。
