School-age spirometry in survivors of chronic lung disease of prematurity in the surfactant era

Abstract

Objective: To assess whether school-age spirometry and lung volume outcomes of preterm infants with history of moderate to severe respiratory distress syndrome (RDS), born in the surfactant era and treated with conventional mechanical ventilation (IMV) and discharged home with or without the diagnosis of BPD (hronic lung disease of prematurity), differ from those of term neonates (controls). Participants: The study included 148 Caucasian school-aged children (38 preterm infants without BPD, 20 preterm infants with BPD and 90 term infants). All infants were born at the Department of Pathology of Pregnancy and Labor, Pomeranian Medical University, Szczecin, Poland. Methods: Respiratory outcome in school-aged children was assessed using spirometry with the evaluation of flow and volume parameters, adjusted for age, weight and gender. The differences in spirometry were tested by the Wilcoxon or Mann-Whitney tests. Linear correlation and regression were also used. Results: No statistically significant differences between the spirometric parameters in preterm infants with and without BPD were found. All investigated parameters were significantly lower in both ventilated groups compared to term controls, with the exception of ERV%, which was significantly higher. Conclusions: The necessity to use assisted ventilation in preterm infants without neurological disorders most probably had an adverse effect on the lung function, assessed by spirometry at the age of 9-10 years, in the groups of children discharged home with or without BPD. Regardless of BPD, lung function parameters in prematurely born children with respiratory distress syndrome are always worse than in term controls.