미숙아로 출생한 학동기 소아에서 폐기능과 임상 양상 사이의 관련성
Relationships between lung function and clinical findings in school-age survivors of preterm birth
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Purpose: Survivors of preterm birth are at high risk of chronic pulmonary disease. We examined lung function in the school-age children born preterm and investigated the relationship between lung function and clinical parameters. Methods: Thirty children born preterm were enrolled and divided into 2 groups: 14 very preterm (<32-week gestational age [GA]) and 16 moderate-to-late preterm (32- to 36-week GA). Pulmonary function tests (PFTs) were performed repeatedly during school-age and PFT parameters were compared with age-matched controls. The relationship between PFT and clinical parameters was also studied. Results: PFT parameters in the very preterm group were persistently reduced compared with age-matched controls (P<0.05). Half of the children had been diagnosed with asthma at the visit for the first PFT. Seventy-seven percent of patients in the very preterm group had bronchial hyperresposiveness. Birth weight, duration of oxygen therapy and mechanical ventilation in the neonatal intensive care unit, and body weight at age 1 were associated with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), or forced expiratory flow between 25% and 75% of expired vital capacity (FEF25%–75%) z-scores. Multiple regression analysis revealed that body weight at age 1 was an independent predictor of FEV1 and FVC z-scores, and duration of oxygen therapy was independently associated with FEF25%–75% z-scores (P<0.01 for all). Conclusion: No catch-up in lung function was observed in school-age children born very preterm. Lower body weight at age 1 might be an independent risk factor for reduced FEV1 and FVC, whereas long-term oxygen therapy might be associated with reduced FEF25%–75%.
Abstract
Purpose: Survivors of preterm birth are at high risk of chronic pulmonary disease. We examined lung function in the school-age children born preterm and investigated the relationship between lung function and clinical parameters. Methods: Thirty children born preterm were enrolled and divided into 2 groups: 14 very preterm (<32-week gestational age [GA]) and 16 moderate-to-late preterm (32- to 36-week GA). Pulmonary function tests (PFTs) were performed repeatedly during school-age and PFT parameters were compared with age-matched controls. The relationship between PFT and clinical parameters was also studied. Results: PFT parameters in the very preterm group were persistently reduced compared with age-matched controls (P<0.05). Half of the children had been diagnosed with asthma at the visit for the first PFT. Seventy-seven percent of patients in the very preterm group had bronchial hyperresposiveness. Birth weight, duration of oxygen therapy and mechanical ventilation in the neonatal intensive care unit, and body weight at age 1 were associated with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), or forced expiratory flow between 25% and 75% of expired vital capacity (FEF25%–75%) z-scores. Multiple regression analysis revealed that body weight at age 1 was an independent predictor of FEV1 and FVC z-scores, and duration of oxygen therapy was independently associated with FEF25%–75% z-scores (P<0.01 for all). Conclusion: No catch-up in lung function was observed in school-age children born very preterm. Lower body weight at age 1 might be an independent risk factor for reduced FEV1 and FVC, whereas long-term oxygen therapy might be associated with reduced FEF25%–75%.
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