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Issues relating to children born prematurely.

Preterm infants suffer increased risk of acute and chronic respiratory disorders. In patients with chronic lung disease or severe bronchopulmonary dysplasia, long-term respiratory morbidity and pulmonary dysfunction into late childhood and early adulthood have been reported. This includes symptomatic morbidity (recurrent cough and/or wheeze) and lung function abnormalities such as increased resistance to airflow, airway hyperresponsiveness, and increased propensity to air-trapping. To date, no clinically significant association between prematurity and classical atopic asthma has been demonstrated. Therefore, interventions should primarily focus on the reduction of wheezing disorders and lung function abnormalities in children born prematurely. In order to design interventions in the foetal and early neonatal period or during childhood the potential risk factors for long-term morbidity need to be carefully identified at different age groups: factors which affect pre- and postnatal lung growth, airway inflammation, viral infections, air pollution and others. Future research issues should include well-conducted prospective follow-up programmes which will identify major risk factors in specific populations. Early intervention will provide information on disease mechanisms and on new prophylactic as well as therapeutic strategies.