Du Berry Cassidy, Mainzer Rheanna M, Westrupp Nicole, FitzGerald Tara, Ranganathan Sarath, Doyle Lex W, Welsh Liam, Cheong Jeanie L Y
Department of Paediatrics.
Respiratory Group, Infection, Immunity and Global Health.
Ann Am Thorac Soc. 2025 May;22(5):732-741. doi: 10.1513/AnnalsATS.202403-244OC.
The effect of moderate to late preterm (MLP) birth (32-36 completed weeks' gestation) on childhood respiratory health is unclear. To assess the effect of being born MLP, compared with being born at term (≥37 completed weeks' gestation), on lung function and respiratory morbidity at 9-10 years of age. A prospective cohort study was conducted among children born MLP or at term at the Royal Women's Hospital (Victoria, Australia). Participants completed pre and postbronchodilator spirometry, measurement of diffusing capacity of the lung for carbon monoxide, plethysmography, and multiple-breath washout at 9-10 years of age. Parents completed the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. Mean differences in -scores of lung function outcomes and risk ratio for ISAAC outcomes between those born MLP and those born at term were estimated using regression models with adjustment for potential confounding. Multiple imputation was used to handle missing data. A total of 148 of 201 children born MLP and 120 of 201 term-born control subjects were assessed at 9-10 years. Compared with control subjects, children born MLP had lower mean -scores for forced expiratory volume in 1 second (mean difference, -0.35 [95% confidence interval (CI), -0.61 to -0.08]), ratio of forced expiratory volume in 1 second to forced vital capacity (mean difference, -0.29 [95% CI, -0.58 to -0.01]), forced expiratory flow at 25-75% of forced vital capacity (-0.33 [95% CI, -0.62 to -0.04]), and diffusing capacity of the lung for carbon monoxide (-0.24 [95% CI, -0.45 to -0.03]). Participants born MLP had higher risk of experiencing asthma symptoms (risk ratio, 1.52 [95% CI, 1.08-2.14]). Children born MLP have lower lung function and increased risk of exhibiting asthma symptoms compared with term-born peers at 9-10 years. Such findings at the end of the first decade of life may portend adverse consequences for respiratory health in adulthood.
中度至晚期早产（32 - 36 足周妊娠）对儿童期呼吸健康的影响尚不清楚。为评估中度至晚期早产（与足月出生[≥37 足周妊娠]相比）对 9 - 10 岁儿童肺功能和呼吸道疾病发病率的影响，在澳大利亚维多利亚州皇家妇女医院对中度至晚期早产或足月出生的儿童进行了一项前瞻性队列研究。参与者在 9 - 10 岁时完成了支气管扩张剂前后的肺量测定、一氧化碳肺弥散量测量、体积描记法和多次呼吸冲洗试验。家长完成了国际儿童哮喘和过敏研究（ISAAC）问卷。使用回归模型并对潜在混杂因素进行调整，估计中度至晚期早产儿童与足月出生儿童在肺功能结果 - 得分方面的平均差异以及 ISAAC 结果的风险比。采用多重填补法处理缺失数据。在 9 - 10 岁时，对 201 名中度至晚期早产出生儿童中的 148 名和 201 名足月出生对照儿童中的 120 名进行了评估。与对照儿童相比，中度至晚期早产出生的儿童在 1 秒用力呼气量方面的平均 - 得分较低（平均差异，-0.35 [95%置信区间(CI)，-0.61 至 -0.08]）、1 秒用力呼气量与用力肺活量之比（平均差异，-0.29 [95%CI，-0.58 至 -0.01]）、用力肺活量 25% - 75%时的用力呼气流量（-0.33 [95%CI，-0.62 至 -0.04]）以及一氧化碳肺弥散量（-0.24 [95%CI，-0.45 至 -0.03]）。中度至晚期早产出生的参与者出现哮喘症状的风险较高（风险比，1.52 [95%CI，1.08 - 2.14]）。与足月出生的同龄人相比，中度至晚期早产出生的儿童在 9 - 10 岁时肺功能较低，出现哮喘症状的风险增加。在生命的第一个十年末出现的这些发现可能预示着成年期呼吸健康的不良后果。
