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中-晚孕期早产儿学龄期肺力学和呼吸并发症

Lung mechanics and respiratory morbidities in school-age children born moderate-to-late preterm.

机构信息

Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Petrolina, Pernambuco, Brazil.

Department of Physical Therapy, Universidade de Pernambuco, Petrolina, Pernambuco, Brazil.

出版信息

Pediatr Res. 2022 Apr;91(5):1136-1140. doi: 10.1038/s41390-021-01538-y. Epub 2021 May 8.

Abstract

BACKGROUND

Late and moderate prematurity may have an impact on pulmonary function during childhood. The present study aimed to investigate lung mechanics in school-age children born moderate-to-late preterm (MLPT).

METHODS

Children aged 5-10 years were enrolled in this case-control study. Lung function and bronchodilator response were assessed by impulse oscillometry (IOS) at two hospital-based specialized clinics. A structured questionnaire was employed to assess respiratory morbidities.

RESULTS

A total of 123 children was divided into two groups: case (MLPT) n = 52 and control (children born at term) n = 71. The results showed no difference between groups in mean baseline IOS variables: R5 0.80 ± 0.20 vs 0.82 ± 0.22 kPa/L/s, p = 0.594, R20 0.54 ± 0.13 vs 0.55 ± 0.13 kPa/L/s, p = 0.732, R5-R20 0.26 ± 0.12 vs 0.27 ± 0.15 kPa/L/s, p = 0.615, X5 -0.29 ± 0.01 vs -0.29 ± 0.1 kPa/L/s, p = 0.990, Fres 21.1 ± 3.3 vs 21.7 ± 3.1 L/s, p = 0.380, and AX 2.7 ± 3.36 vs 2.5 ± 1.31 kPa/L/s, p = 0.626. Bronchodilator response and the occurrence of respiratory morbidities after birth were also similar between groups.

CONCLUSIONS

This study found lung mechanics parameters to be similar in school-age children born MLPT and those born at term, suggesting that pulmonary plasticity continues to occur in children up to school age.

IMPACT

Late and moderate prematurity is associated with an increased risk of reduced pulmonary function during childhood. Follow-up reports in adolescents and adults born MLPT are scarce but have indicated pulmonary plasticity with normalization of airway function. Our results show that the lung function in school-age children born MLPT is similar to that of children born at term.

摘要

背景

晚期和中度早产儿可能会对儿童期的肺功能产生影响。本研究旨在探讨中度至晚期早产儿(MLPT)的学龄儿童的肺力学。

方法

本病例对照研究纳入了年龄在 5-10 岁的儿童。在两个医院专科诊所,通过脉冲振荡法(IOS)评估肺功能和支气管扩张剂反应。采用结构化问卷评估呼吸疾病。

结果

共有 123 名儿童分为两组:病例组(MLPT)n=52 例和对照组(足月产儿童)n=71 例。结果显示,两组间平均基础 IOS 变量无差异:R5 0.80±0.20 vs 0.82±0.22 kPa/L/s,p=0.594,R20 0.54±0.13 vs 0.55±0.13 kPa/L/s,p=0.732,R5-R20 0.26±0.12 vs 0.27±0.15 kPa/L/s,p=0.615,X5 -0.29±0.01 vs -0.29±0.1 kPa/L/s,p=0.990,Fres 21.1±3.3 vs 21.7±3.1 L/s,p=0.380,AX 2.7±3.36 vs 2.5±1.31 kPa/L/s,p=0.626。支气管扩张剂反应和出生后呼吸疾病的发生在两组间也相似。

结论

本研究发现,MLPT 出生的学龄儿童的肺力学参数与足月产儿童相似,提示肺的可塑性在儿童期持续发生。

影响

晚期和中度早产儿与儿童期肺功能降低的风险增加相关。对 MLPT 出生的青少年和成年人的随访报告很少,但表明气道功能正常化的肺可塑性。我们的研究结果表明,MLPT 出生的学龄儿童的肺功能与足月产儿童相似。

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