Department of Neonatology, Rambam Health Care Campus, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Pediatr Pulmonol. 2021 Jun;56(6):1609-1616. doi: 10.1002/ppul.25329. Epub 2021 Mar 3.
To describe the long-term (up to 18 years of age) respiratory outcomes of children and adolescents born at very low birth weight (VLBW; ≤1500 g) in comparison with that of children born >1500 g.
An observational, longitudinal, retrospective study comparing VLBW infants with matched controls, registered at a large health maintenance organization in Israel. Pulmonary outcomes collected anonymously from the electronic medical files included respiratory illness diagnoses, purchased medications for respiratory problems, office visits with either a pediatric pulmonologist or cardiologist and composite respiratory morbidity combining all these parameters.
Our study included 5793 VLBW infants and 11,590 matched controls born between 1998 and 2012. The majority (99%) of VLBW infants were premature (born < 37 weeks' gestation), while 93% of controls were born at term. The composite respiratory morbidity was significantly higher in VLBW infants compared with controls in all age groups (relative risk [95% confidence interval]: 1 year: 1.22 [1.19-1.26], <2 years: 1.30 [1.27-1.34], 2-6 years: 1.29 [1.27-1.32], 6-12 years: 1.53 [1.47-1.59], 12-18 years: 1.46 [1.35-1.56]; respectively). Both VLBW infants and controls demonstrated a steady decline in the composite respiratory morbidity with aging. In VLBW infants, lower gestational age was associated with higher respiratory morbidity only until 2 years of age and the morbidity declined in each gestational age group until adolescence.
Our study confirmed a strong association between VLBW and pulmonary morbidity. The higher prevalence of respiratory composite morbidity in VLBW infants persists over the years until adolescence. The respiratory morbidity is most evident in the first year of life and declines afterward.
描述极低出生体重儿（VLBW；≤1500g）与出生体重大于 1500g 的儿童相比，其长期（长达 18 岁）的呼吸结局。
这是一项在以色列一家大型医疗保健组织注册的观察性、纵向、回顾性研究，比较了 VLBW 婴儿与匹配对照。从电子病历中匿名收集的肺部疾病结果包括呼吸道疾病诊断、购买的呼吸道问题药物、与儿科肺科医生或心脏病专家的门诊就诊以及综合呼吸道发病率，综合所有这些参数。
我们的研究纳入了 1998 年至 2012 年间出生的 5793 名 VLBW 婴儿和 11590 名匹配对照。大多数（99%）VLBW 婴儿为早产儿（出生<37 周），而 93%的对照婴儿为足月出生。在所有年龄组中，VLBW 婴儿的综合呼吸道发病率均显著高于对照组（相对风险[95%置信区间]：1 岁：1.22[1.19-1.26]，<2 岁：1.30[1.27-1.34]，2-6 岁：1.29[1.27-1.32]，6-12 岁：1.53[1.47-1.59]，12-18 岁：1.46[1.35-1.56]）。VLBW 婴儿和对照组均表现出随着年龄增长，综合呼吸道发病率稳步下降。在 VLBW 婴儿中，较低的胎龄仅与 2 岁前更高的呼吸道发病率相关，并且每个胎龄组的发病率在青春期前下降。
本研究证实了 VLBW 与肺部发病率之间存在很强的关联。VLBW 婴儿的呼吸道复合发病率多年来一直持续升高，直到青春期。呼吸道发病率在生命的第一年最为明显，此后逐渐下降。
