Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia.

Abstract

Background The relationship between early life factors and childhood pulmonary function and structure in preterm infants remains unclear. Purpose This study investigated the impact of bronchopulmonary dysplasia (BPD) and perinatal factors on childhood pulmonary function and structure. Methods This longitudinal cohort study included preterm participants aged ≥5 years born between 2005 and 2015. The children were grouped by BPD severity according to National Institutes of Health criteria. Pulmonary function tests (PFTs) were performed using spirometry. Chest computed tomography (CT) scans were obtained and scored for hyperaeration or parenchymal lesions. PFT results and chest CT scores were analyzed with perinatal factors. Results A total 150 children (66 females) aged 7.7 years (6.4-9.9 years) were categorized into non/mild BPD (n=68), moderate BPD (n=39), and severe BPD (n=43) groups. The median z score for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced midexpiratory flow (FEF25%-75%) were significantly lower in the severe versus non/mild BPD group (-1.24 vs. -0.18, -0.22 vs. 0.41, -1.80 vs. -1.12, and -1.88 vs. -1.00, respectively; all P<0.05). The median z scores of FEV1, FEV1/ FVC, and FEF25%-75% among asymptomatic patients were also significantly lower in the severe versus non/mild BPD group (-0.82 vs. 0.09, -1.68 vs. -0.87, -1.59 vs. -0.61, respectively; all P<0.05). The severe BPD group had a higher median (range) CT score than the non/mild BPD group (6 [0-12] vs. 1 [0-10], P<0.001). Prenatal oligohydramnios was strongly associated with both low pulmonary function (FEV1/FVC

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低水肿会影响支气管肺发育不良学龄儿童的肺功能/结构异常。

背景早产儿的早期生活因素与儿童期肺功能和结构之间的关系仍不清楚。目的本研究调查了支气管肺发育不良（BPD）和围产期因素对儿童期肺功能和结构的影响。方法这项纵向队列研究纳入了 2005 年至 2015 年间出生的年龄≥5 岁的早产儿。根据美国国立卫生研究院的标准，按BPD严重程度对儿童进行分组。肺功能测试（PFT）采用肺活量测定法进行。采集胸部计算机断层扫描（CT）扫描结果，并对高渗或实质病变进行评分。结果 150 名儿童（66 名女性）被分为非/轻度 BPD 组（68 名）、中度 BPD 组（39 名）和重度 BPD 组（43 名），年龄为 7.7 岁（6.4-9.9 岁）。与非/轻度 BPD 组相比，重度 BPD 组患者 1 秒钟用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC 比值和用力侧呼气流量（FEF25%-75%）的中位数 z 评分明显较低（分别为-1.24 vs. -0.18、-0.22 vs. 0.41、-1.80 vs. -1.12 和-1.88 vs. -1.00; 均 P<0.05）。无症状患者的 FEV1、FEV1/ FVC 和 FEF25%-75% 的中位 Z 评分在重度 BPD 组和非轻度 BPD 组之间也有显著差异（分别为-0.82 vs. 0.09、-1.68 vs. -0.87、-1.59 vs. -0.61；所有 P 均<0.05）。重度 BPD 组的 CT 评分中位数（范围）高于非/轻度 BPD 组（6 [0-12] vs. 1 [0-10]，P<0.001）。产前少水肿与肺功能低下（FEV1/FVC<正常值下限；几率比，3.54）和 CT 评分高（中位数差异，2.54）密切相关。这些结果表明，产前有少水症或长期机械通气史的患者需要延长随访时间。

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