Jussinniemi Laura, Benum Silje D, Aakvik Kristina A D, Kulmala Maarit K, Jørgensen Anna P M, Andersson Sture, Hovi Petteri, Leppänen Heli-Kaisa, Steinshamn Sigurd, Evensen Kari Anne I, Kajantie Eero
Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Welfare Epidemiology and Monitoring Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Pediatr Res. 2025 Jun 28. doi: 10.1038/s41390-025-04246-z.
Young adults born preterm with very low birth weight (VLBW; <1500 g), especially those who had neonatal bronchopulmonary dysplasia (BPD), have reduced lung function compared with their term-born peers. We hypothesized that these impairments worsen between young and mid-adulthood.
We studied two birth cohorts: HeSVA (Finland) and NTNU LBW Life (Norway) with harmonized protocols. Lung function was assessed by spirometry in 115 VLBW (20 with BPD) and 142 controls at mean 36 years. The results were compared with young adulthood (22 years) spirometry in 198 VLBW (32 with BPD) and 225 control participants.
In mid-adulthood, BPD-VLBW adults had lower z-scores in forced expiratory volume in 1 s (zFEV1; mean difference -1.49; 95%CI -1.94, -1.04) and in zFEV1/FVC (FVC: forced vital capacity; mean difference -0.84, 95%CI -1.23, -0.44) than controls. Corresponding differences for non-BPD-VLBW adults were -0.34 (95%CI -0.60, -0.08) and -0.30 (95%CI -0.53, -0.07). The differences in zFVC and zFEV1 between BPD-VLBW and control groups increased from young to mid-adulthood.
In mid-adulthood, adults born preterm with VLBW had reduced airflow compared with term-born controls. These differences were more pronounced among those with a history of BPD, whose vital capacity also seems to decline faster.
Impaired airflow and reduced vital capacity in VLBW adults do not improve with age. Among those with a history of BPD, vital capacity seems to reduce faster than among their term-born peers. Clinicians who see adults born preterm with VLBW should be vigilant for respiratory symptoms. We argue that a full medical history in all adults who present with respiratory symptoms should routinely include key birth characteristics such as preterm birth.
出生时体重极低（VLBW；<1500克）的年轻成年人，尤其是那些患有新生儿支气管肺发育不良（BPD）的人，与足月儿同龄人相比，肺功能有所下降。我们假设这些损害在青年期和中年期之间会恶化。
我们研究了两个出生队列：HeSVA（芬兰）和挪威科技大学低体重儿生活队列（挪威），采用统一方案。在平均36岁时，通过肺活量测定法对115名极低出生体重儿（20名患有BPD）和142名对照者进行肺功能评估。将结果与198名极低出生体重儿（32名患有BPD）和225名对照参与者在青年期（22岁）时的肺活量测定结果进行比较。
在中年期，患有BPD的极低出生体重儿成年人的1秒用力呼气量（zFEV1；平均差异-1.49；95%CI -1.94，-1.04）和zFEV1/FVC（FVC：用力肺活量；平均差异-0.84，95%CI -1.23，-0.44）的z分数低于对照组。非BPD极低出生体重儿成年人的相应差异为-0.34（95%CI -0.60，-0.08）和-0.30（95%CI -0.53，-0.07）。患有BPD的极低出生体重儿组和对照组之间的zFVC和zFEV1差异从青年期到中年期有所增加。
在中年期，出生时体重极低的成年人与足月儿对照组相比，气流减少。这些差异在有BPD病史的人群中更为明显，他们的肺活量似乎也下降得更快。
极低出生体重儿成年人的气流受损和肺活量降低不会随着年龄增长而改善。在有BPD病史的人群中，肺活量似乎比足月儿同龄人下降得更快。诊治出生时体重极低的成年人的临床医生应警惕呼吸道症状。我们认为，所有出现呼吸道症状的成年人的完整病史应常规包括早产等关键出生特征。
