Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadephia, Philadelphia, Pennsylvania, USA.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pediatr Pulmonol. 2022 Oct;57(10):2481-2490. doi: 10.1002/ppul.26064. Epub 2022 Jul 14.
Animal models suggest pre-eclampsia (Pre-E) affects alveolar development, but data from humans are lacking.
Assess the impact of Pre-E on airway function, diffusion capacity, and respiratory morbidity in preterm and term infants born from mothers with Pre-E.
Infants born from mothers with and without Pre-E were recruited for this study; term and preterm infants were included in both cohorts. Respiratory morbidity in the first 12 months of life was assessed through monthly phone surveys. Raised volume rapid thoracoabdominal compression and measurement of diffusion capacity of the lung to carbon monoxide (DLCO) were performed at 6 months corrected age.
There were 146 infants in the Pre-E cohort and 143 in the control cohort. The Pre-E cohort was further divided into nonsevere (N = 41) and severe (N = 105) groups. There was no significant difference in DLCO and DLCO/alveolar volume among the three groups. Forced vital capacity was similar among the three groups, but the nonsevere Pre-E group had significantly higher forced expiratory flows than the other two groups. After adjusting for multiple covariates including prematurity, the severe Pre-E group had a lower risk for wheezing in the first year of life compared to the other two groups.
Pre-E is not associated with reduced DLCO, lower forced expiratory flows, or increased wheezing in the first year of life. These results differ from animal models and highlight the complex relationships between Pre-E and lung function and respiratory morbidity in human infants.
动物模型表明先兆子痫(Pre-E)会影响肺泡发育,但人类的数据尚缺乏。
评估先兆子痫对患有先兆子痫的母亲所生早产儿和足月儿的气道功能、弥散能力和呼吸发病率的影响。
本研究招募了患有和不患有先兆子痫的母亲所生的婴儿;这两个队列都包括早产儿和足月儿。通过每月电话调查评估生命最初 12 个月的呼吸发病率。在 6 个月的校正年龄时进行抬高容量快速胸腹腔压缩和测量肺一氧化碳弥散量(DLCO)。
Pre-E 队列有 146 名婴儿,对照组有 143 名婴儿。Pre-E 队列进一步分为非严重(N=41)和严重(N=105)组。三组间的 DLCO 和 DLCO/肺泡容积无显著差异。用力肺活量在三组间相似,但非严重 Pre-E 组的用力呼气流量明显高于其他两组。在调整包括早产在内的多个协变量后,严重 Pre-E 组在生命的第一年发生喘息的风险低于其他两组。
先兆子痫与 DLCO 降低、呼气流量降低或生命第一年喘息增加无关。这些结果与动物模型不同,强调了先兆子痫与人类婴儿的肺功能和呼吸发病率之间的复杂关系。