Original article
Respiratory Health in Prematurely Born Preschool Children with and without Bronchopulmonary Dysplasia

https://doi.org/10.1016/j.jpeds.2006.12.007Get rights and content

Objective

To investigate the respiratory health of preterm infants with bronchopulmonary dysplasia (BPD) at preschool age and to determine whether lung function (measured by forced oscillation technique (FOT) and interruption technique (Rint) is affected by BPD in preterm infants compared with preterm infants without BPD.

Study design

Participants: 3 to 5 years of age born preterm with BPD (N = 40, mean gestational age 28 weeks, mean birth weight 1051 g), and without BPD (N = 36, mean gestational age 29 weeks, mean birth weight 1179 g). Outcome variables: prevalence of symptoms determined by European Community Respiratory Health Survey and lung function measured by FOT and Rint.

Results

A large percentage of infants in both preterm groups reported respiratory symptoms during the last 12 months. Lung function measurements showed higher resonant frequency (Hz) in BPD compared with non-BPD (mean 26.8 vs 22.7, P < .001) and lower mean reactance X4-24 (hPa.s/l)(–3.0 vs –1.9, P = .005). No differences were found in respiratory resistance between the groups, although the mean values of both groups were increased compared with reference values.

Conclusion

Preterm birth affects respiratory health at 3 to 5 years of age. Children with BPD could be distinguished from children without BPD based on a higher resonant frequency and a lower mean reactance.

Section snippets

Study Groups

Children with a history of BPD, born prematurely between 1998 and 2001 and treated in the neonatal intensive care unit of the Beatrix Children’s Hospital, were invited to participate in this study. BPD was defined as the need for continuous supplemental oxygen at 28 days of age combined with radiographic manifestations. These abnormalities include hyperinflation and nonhomogeneity of pulmonary tissues, with diffuse haziness, or fine or coarser densities extending to the periphery. According to

Participants

Of the 122 eligible prematurely born patients (64 children with BPD and 58 matched prematurely born children without BPD), 77 (63%: 41 BPD and 36 no BPD) agreed to participate in this study (Table I). No differences were found between the (77) participants and (45) “nonparticipants” with regard to gestational age or birth weight. From the nonparticipants, 8 children had moved, 1 child was not able to participate because of a tracheotomy, 5 parents refused to give permission, and 31 parents did

Discussion

Premature birth, particularly when complicated by the subsequent development of BPD, has been associated with respiratory morbidity in early childhood. This study shows that children with BPD do not report having more respiratory symptoms, but they do have lung function abnormalities (i.e. a lower mean reactance and a higher resonance frequency), indicating decreased compliance, compared with premature children without BPD. Another important finding is that FOT is able to discriminate between

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