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Altered lung structure and function in mid-childhood survivors of very preterm birth.
Simpson, Shannon J; Logie, Karla M; O'Dea, Christopher A; Banton, Georgia L; Murray, Conor; Wilson, Andrew C; Pillow, J Jane; Hall, Graham L.
Afiliação
  • Simpson SJ; Telethon Kids Institute, Perth, WA, Australia.
  • Logie KM; Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.
  • O'Dea CA; Telethon Kids Institute, Perth, WA, Australia.
  • Banton GL; School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
  • Murray C; Telethon Kids Institute, Perth, WA, Australia.
  • Wilson AC; Department of Respiratory and Sleep Medicine, Princess Margaret Hospital for Children, Perth, WA, Australia.
  • Pillow JJ; School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
  • Hall GL; Telethon Kids Institute, Perth, WA, Australia.
Thorax ; 72(8): 702-711, 2017 08.
Article em En | MEDLINE | ID: mdl-28119488
RATIONALE: Survivors of preterm birth are at risk of chronic and lifelong pulmonary disease. Follow-up data describing lung structure and function are scarce in children born preterm during the surfactant era. OBJECTIVES: To obtain comprehensive data on lung structure and function in mid-childhood from survivors of preterm birth. We aimed to explore relationships between lung structure, lung function and respiratory morbidity as well as early life contributors to poorer childhood respiratory outcomes. METHODS: Lung function was tested at 9-11 years in children born at term (controls) and at ≤32 weeks gestation. Tests included spirometry, oscillatory mechanics, multiple breath nitrogen washout and diffusing capacity of the lung for carbon monoxide. Preterm children had CT of the chest and completed a respiratory symptoms questionnaire. MAIN RESULTS: 58 controls and 163 preterm children (99 with bronchopulmonary dysplasia) participated. Preterm children exhibited pulmonary obstruction and hyperinflation as well as abnormal peripheral lung mechanics compared with term controls. FEV1 was improved by 0.10 z-scores for every additional week of gestation (95% CI 0.028 to 0.182; p=0.008) and by 0.34 z-scores per z-score increase in birth weight (0.124 to 0.548; p=0.002). Structural lung changes were present in 92% of preterm children, with total CT score decreased by 0.64 (-0.99 to -0.29; p<0.001) for each additional week of gestation. Obstruction was associated with increased subpleural opacities, bronchial wall thickening and hypoattenuated lung areas on inspiratory chest CT scans (p<0.05). CONCLUSIONS: Abnormal lung structure in mid-childhood resulting from preterm birth in the contemporary era has important functional consequences.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Capacidade Vital / Volume Expiratório Forçado / Lactente Extremamente Prematuro / Pulmão / Pneumopatias Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male / Newborn Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Capacidade Vital / Volume Expiratório Forçado / Lactente Extremamente Prematuro / Pulmão / Pneumopatias Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male / Newborn Idioma: En Ano de publicação: 2017 Tipo de documento: Article