Long-term lung function follow-up of preterm infants less than 32 weeks of gestational age.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2024-11-01 Epub Date: 2024-07-03 DOI:10.1002/ppul.27158

Amaia Merino-Hernández, Agustin Muñoz-Cutillas, Cristina Ramos-Navarro, Sara Bellón-Alonso, Juan Luis Rodríguez-Cimadevilla, Noelia González-Pacheco, Rosa Rodríguez-Fernández, Manuel Sánchez-Luna

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引用次数: 0

Abstract

Background: Preterm infants, particularly those with bronchopulmonary dysplasia (BPD), are at risk of lung development problems. Over the last decades, lung protective strategies have been used, decreasing the risk of chronic lung disease.

Objective: To evaluate the pulmonary function test (PFT) of preterm infants born after the introduction of lung protective strategies and to assess perinatal determinants of impaired lung function in this population.

Methods: A prospective, observational, single-center study was conducted in the neonatal unit of a high-complexity hospital. The study included newborns with less than 32 weeks gestational age born between 2012 and 2014, who were followed up until they reach school age. For the main outcome, two groups were stablished: no BPD or grade 1 BPD (no BPD/1) and grade 2 or 3 BPD (BPD 2/3).

Results: Out of 327 patients, 116 were included. BPD was diagnosed in 49.1% (47), with 50.9% (29) classified as grade 1, 35.1% (20) as grade 2, and 14.0% (8) as grade 3. Mean age at PFT was 8.59 years (SD 0.90). Mean FEV1% was 95.36% (SD 13.21) and FEV1 z-score -0.36 (SD 1.12); FVC% 97.53% (SD 12.59) and FVC z-score -0.20 (SD 1.06); FEV1/FVC ratio 85.84% (SD 8.34) and z-score -0.24 (SD 1.34). When comparing patients with no BPD/1 and BPD 2/3, we observed differences in all pulmonary function parameters, which persisted after adjusting for gestational age. No differences in PFT were observed between patients without BPD and those with grade 1 BPD. Most patients (76.7%, 89) had normal spirometry pattern, with obstructive pattern observed in 12.9% (15), restrictive pattern in 9.5% (11), and mixed pattern in 0.9% (1) of patients.

Conclusion: Preterm infants with BPD 2/3 showed a decrease in all pulmonary function parameters compared to preterm infants with no BPD/1; an effect that was independent of gestational age. Among patients with BPD who had an altered PFT pattern, the most common pattern was obstructive, followed by restrictive and then, mixed.

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对胎龄不足 32 周的早产儿进行长期肺功能随访。

背景：早产儿，尤其是患有支气管肺发育不良（BPD）的早产儿，有可能出现肺发育问题。在过去的几十年中，人们一直在使用肺保护策略，以降低患慢性肺部疾病的风险：评估肺保护策略引入后早产儿的肺功能测试（PFT），并评估该人群肺功能受损的围产期决定因素：一项前瞻性、观察性、单中心研究在一家高复杂性医院的新生儿科进行。研究对象包括 2012 年至 2014 年间出生的胎龄小于 32 周的新生儿，对他们进行随访，直至他们达到入学年龄。主要结果分为两组：无BPD或1级BPD（无BPD/1）和2级或3级BPD（BPD 2/3）：结果：在 327 名患者中，有 116 人被纳入。49.1%（47 人）的患者被诊断为 BPD，其中 50.9%（29 人）为 1 级，35.1%（20 人）为 2 级，14.0%（8 人）为 3 级。PFT 时的平均年龄为 8.59 岁（SD 0.90）。平均 FEV1% 为 95.36% (SD 13.21)，FEV1 z 评分为 -0.36 (SD 1.12)；FVC% 为 97.53% (SD 12.59)，FVC z 评分为 -0.20 (SD 1.06)；FEV1/FVC 比值为 85.84% (SD 8.34)，z 评分为 -0.24 (SD 1.34)。在比较无 BPD/1 和 BPD 2/3 的患者时，我们观察到了所有肺功能参数的差异，这种差异在调整胎龄后依然存在。未患有 BPD 的患者与患有 1 级 BPD 的患者在 PFT 方面没有差异。大多数患者（76.7%，89 例）的肺活量模式正常，阻塞型占 12.9%（15 例），限制型占 9.5%（11 例），混合型占 0.9%（1 例）：结论：与未患有 BPD/1 的早产儿相比，患有 BPD 2/3 的早产儿的所有肺功能指标均有所下降；这种影响与胎龄无关。在PFT模式发生改变的BPD患者中，最常见的模式是阻塞性，其次是限制性，然后是混合型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.