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From neonatal lung function to lung function and respiratory morbidity at 6-year follow-up.

BACKGROUND
Lung function is traceable from infancy to adulthood. Only a few studies have examined lung function from birth to childhood longitudinally in children born moderate to late preterm. We aimed to investigate how prematurity and lung function in the neonatal period are related to lung function and respiratory morbidity at age six in former moderate to late preterm children compared with children born at term.


METHOD
Lung function was measured in a cohort of moderately to late preterm (n = 48) and term-born (n = 53) infants in the neonatal period by FeNO, and tidal breathing flow-volume loops (TBFVL) and at age six (n = 52) by spirometry, whole-body plethysmograph and impulse oscillation combined with a respiratory symptom questionnaire.


RESULTS
Moderate to late preterm children had a higher TPEF /TE ratio neonatally (42.6 % vs 33.7 %, p = 0.02) and a lower % predicted FEV1 at age six (94.4 % vs 101.9 %, p = 0.01) compared to term-born children. We found a significant association between the variability of neonatal tidal volume and effective airway resistance at age six (β = -0.34, p = 0.03). No association between neonatal FeNO or TBFVL and respiratory morbidity at six-year follow-up was shown.


CONCLUSION
Children born moderate to late preterm had lower lung function at age six than term-born children. We did not find evidence for the use of neonatal tidal breathing parameters as a predictor for subsequent respiratory morbidity or lung function, however sample size was small. This article is protected by copyright. All rights reserved.