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极早早产青年成人分娩时的劳动状态与肺功能

Labor Status at Delivery and Lung Function in Extremely Prematurely Born Young Adults.

作者信息

Armstrong Sean, Harris Christopher, Kazemi Mohadeseh, Lunt Alan, Peacock Janet, Greenough Anne

机构信息

Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.

Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire, USA.

出版信息

Pediatr Pulmonol. 2025 Jan;60(1):e27440. doi: 10.1002/ppul.27440. Epub 2024 Dec 16.

Abstract

BACKGROUND

There has been conflicting evidence regarding the impact of mode of delivery on respiratory outcomes in later childhood and adulthood. It is possible labor status, rather than mode of delivery, influences later respiratory morbidity. We hypothesized that extremely premature infants born to mothers in labor would have better lung function at follow-up than those born to mothers not in labor.

METHODS

We reviewed data from the United Kingdom High-Frequency Oscillation Study. Lung function testing was performed on young people aged 16-18 years born before 29 weeks of gestation. Linear mixed models were used to adjust lung function for maternal and neonatal factors and for the clustering due to multiple births.

RESULTS

One hundred and fifty subjects underwent lung function testing. Young adults born to mothers in labor had better mean Forced Expiratory Flow (FEF) compared to those born to mothers not in labor (adjusted difference 0.50 [95% CI: 0.02, 0.99]). Similar significant differences were noted in FEF (0.45 [-0.05, 0.85]), and FEF (0.53 [0.05, 1.01]).

CONCLUSION

Our study demonstrates that amongst individuals born very prematurely, those whose mothers were in labor before delivery had better small airway function at 16-19 years of age.

摘要

背景

关于分娩方式对儿童后期及成年期呼吸结局的影响,证据存在矛盾。可能是分娩状态而非分娩方式影响后期呼吸系统发病率。我们假设,与母亲未处于分娩状态的极早产儿相比,母亲处于分娩状态的极早产儿在随访时肺功能更好。

方法

我们回顾了英国高频振荡研究的数据。对妊娠29周前出生的16 - 18岁青少年进行肺功能测试。使用线性混合模型对肺功能进行调整,以考虑母亲和新生儿因素以及多胞胎导致的聚类情况。

结果

150名受试者接受了肺功能测试。与母亲未处于分娩状态的年轻人相比,母亲处于分娩状态的年轻成年人平均用力呼气流量(FEF)更好(调整后差异0.50 [95%置信区间:0.02, 0.99])。在FEF(0.45 [-0.05, 0.85])和FEF(0.53 [0.05, 1.01])方面也观察到类似的显著差异。

结论

我们的研究表明,在极早产儿中,母亲在分娩前处于分娩状态的个体在16 - 19岁时小气道功能更好。

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本文引用的文献

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Are children born by cesarean delivery at higher risk for respiratory sequelae?剖宫产出生的儿童患呼吸道后遗症的风险更高吗?
Am J Obstet Gynecol. 2022 Feb;226(2):257.e1-257.e11. doi: 10.1016/j.ajog.2021.07.027. Epub 2021 Aug 5.
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Lung function and exercise capacity in prematurely born young people.肺功能和运动能力在早产儿中的表现。
Pediatr Pulmonol. 2020 Sep;55(9):2289-2295. doi: 10.1002/ppul.24918. Epub 2020 Jun 29.
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Lung Function of Adults Born at Very Low Birth Weight.极低出生体重儿的成人肺部功能。
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