REVIEW   

Minerva Pneumologica 2017 June;56(2):139-51

DOI: 10.23736/S0026-4954.17.01781-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Respiratory outcomes after preterm birth

Kylie HART, Michael COUSINS, Sailesh KOTECHA ✉

Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK

Mortality of preterm-born infants continues to improve but long-term morbidity continues to be a challenge. Increased respiratory symptoms, impaired respiratory function and increased exercise induced bronchoconstriction (EIB) are significant and can have life-long consequences in terms of hospitalization, limitations in normal daily activities and potentially early development of chronic obstructive pulmonary disease. Decreased lung spirometry is well recognized in preterm-born children especially in those who developed chronic lung disease of prematurity (CLD) in infancy. In addition, preterm-born children may have altered breathing patterns which imply inherent structural differences (e.g. increased dead space) that affects their ventilation especially during exertion. Synthesized results for cardiopulmonary exercise testing in preterm-born children show lower maximal oxygen consumption (V̇O2max) than term-born controls. Increased EIB has been demonstrated in preterm-born children, with greater incidence identified in those who had CLD, when compared with term-born controls. However, there remains a lack of studies evaluating the efficacy of inhaled medications in the preterm born population. This review examines the role of spirometry and cardiopulmonary exercise testing, alongside current evidence relating to lung function and exercise capacity in children and young adults who were born preterm.

KEY WORDS: Premature birth - Lung - Physiology - Bronchopulmonary dysplasia - Bronchoconstriction - Bronchodilator agents