Longitudinal Evaluation of Airway Function 21 Years after Preterm Birth

• Published in: American journal of respiratory and critical care medicine Vol. 178; no. 1; pp. 74 - 80
• Main Authors: Narang, Indra, Rosenthal, Mark, Cremonesini, David, Silverman, Mike, Bush, Andrew
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 01.07.2008; American Lung Association; American Thoracic Society
• Subjects: Adult; Adults; Airway management; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Asthma; Biological and medical sciences; Birth weight; Bronchial Hyperreactivity - diagnosis; Child; Confidence intervals; Emergency and intensive respiratory care; Female; Follow-Up Studies; Forced Expiratory Volume; Gestational age; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Very Low Birth Weight; Intensive care medicine; Longitudinal studies; Male; Maximal Midexpiratory Flow Rate; Medical sciences; Morbidity; Pregnancy; Premature Birth; Questionnaires; Respiratory Function Tests; Respiratory Tract Diseases - diagnosis; Smoking; Spirometry; Surfactants; Ventilators; Vital Capacity; United Kingdom > UK; Spirometry; airway hyperresponsiveness; Intensive care; respiratory symptoms; Prematurity; Resuscitation
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.200705-701OC

There are limited longitudinal data about respiratory morbidity and lung function after preterm birth into adulthood. To determine the evolution of respiratory symptoms, spirometry, and airway hyperresponsiveness of ex-preterm subjects from childhood into adulthood. Ex-preterm subjects (median birth weight, 1,440 g; median gestation, 31.5 wk), recruited at birth (not treated with surfactant), had excess respiratory symptoms, airway obstruction, and increased airway hyperresponsiveness in mid-childhood. At a median age of 21.7 years, 60 of these subjects (the index study group) and 50 healthy term control subjects were recruited to determine respiratory morbidity and spirometry. Respiratory symptom questionnaire, spirometry, and methacholine challenge test. The index study group had significantly more respiratory symptoms (16 of 60) than did control subjects (4 of 50) (odds ratio, 4.2; 95% confidence interval, 1.3 to 13.5; P = 0.01), but no significant difference in measured spirometry. Specifically, in the index study group and control subjects, the mean z scores (95% confidence interval of the group difference) for the FEV(1) were -0.60 and -0.58 (-0.44 to 0.49), respectively (P = 0.92); for the forced mid-expiratory flow they were -1.02 and -0.86 (-0.33 to 0.64), respectively (P = 0.52); and for the FVC they were -0.29 and -0.33 (-0.46 to 0.38), respectively (P = 0.85). Ex-preterm adults did not show evidence of increased airway hyperresponsiveness compared with control subjects, 23 and 19%, respectively (P = 0.89). There are still excess respiratory symptoms 21 years after preterm birth. Reassuringly, this longitudinal study did not show evidence of persistent airway obstruction or airway hyperresponsiveness in ex-preterm adults.