Source: Annual Congress 2002 - Early influences on respiratory health and disease
Disease area: Airway diseases, Paediatric lung diseases

Abstract

A cohort of 265 very low birth weight (VLBW, <1500g) children were followed from birth during the peri-surfactant era 8/1/1988-6/30/1991 to age 10 years. At 30 days, infants were classified as having bronchopulmonary dysplasia (BPD)(Group A) by oxygen use and x-rays, as having no respiratory disease by absence of respiratory support and x-ray findings (Group C), or otherwise as having mild respiratory disease (Group B). At age 10, respiratory testing was performed by the Jaeger AM1. Questionnaire data at ages 8 and 10 included information on respiratory symptoms (wheezing or shortness of breath) and respiratory medication use. Results show that symptom prevalence decreased in Group A from 69% for births pre-surfactant (before 8/1/1989) to 18% post surfactant (after 8/1/1990)(p=0.0043). Symptom prevalence increased in Group B (from 22% to 33%, n.s.) and in Group C (from 38% to 49%, n.s.). Among those with symptoms, medication use at age 10 increased for Group C (from 17% to 59%, p=0.0073), but decreased from 60% to 0% for those in the other two groups. Mean FEV1 ratio (observed over expected) improved in Group C (from 0.86 to 0.92, p=0.02), decreased in Group B, (from 0.89 to 0.82, p=0.09) and remained approximately 0.80 for Group A. FEV1 was lower (by 0.03, p=0.06) with family history of asthma, and for boys (by 0.04, p=0.0071). Neonates with BPD were smaller, especially post surfactant. It may be speculated that their disease may be less responsive to medication. A classification of respiratory testing results to separate restrictive and obstructive patterns hinted at an increase in a restrictive component among children with BPD. Obstructive disease at age 10 was present even among children seemingly free of disease in infancy.

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M. Palta, M. Sadek-Badawi, H. Said, K. A. Madden, A. Albanese, C. G. Green (Madison, United States Of America). Respiratory health of very low birth weight children born during the perisurfactant era. Eur Respir J 2002; 20: Suppl. 38, 1135

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