Very prematurely born infants wheezing at follow-up: lung function and risk factors

Broughton, Simon, Thomas, Mark R., Marston, Louise, Calvert, Sandra A., Marlow, Neil, Peacock, Janet L., Rafferty, Gerrard F. and Greenough, Anne (2007) Very prematurely born infants wheezing at follow-up: lung function and risk factors. Archives of Disease in Childhood, 92 (9), 776-780. (doi:10.1136/adc.2006.112623).

Abstract

OBJECTIVES: To determine whether abnormalities of lung volume and/or airway function were associated with wheeze at follow-up in infants born very prematurely and to identify risk factors for wheeze. DESIGN: Lung function data obtained at 1 year of age were collated from two cohorts of infants recruited into the UKOS and an RSV study, respectively. SETTING: Infant pulmonary function laboratory. PATIENTS: 111 infants (mean gestational age 26.3 (SD 1.6) weeks). INTERVENTIONS: Lung function measurements at 1 year of age corrected for gestational age at birth. Diary cards and respiratory questionnaires were completed to document wheeze. MAIN OUTCOME MEASURES: Functional residual capacity (FRC(pleth) and FRC(He)), airways resistance (R(aw)), FRC(He):FRC(pleth) and tidal breathing parameters (T(PTEF):T(E)). RESULTS: The 60 infants who wheezed at follow-up had significantly lower mean FRC(He), FRC(He):FRC(pleth) and T(PTEF):T(E), but higher mean R(aw) than the 51 without wheeze. Regression analysis demonstrated that gestational age, length at assessment, family history of atopy and a low FRC(He):FRC(pleth) were significantly associated with wheeze. CONCLUSIONS: Wheeze at follow-up in very prematurely born infants is associated with gas trapping, suggesting abnormalities of the small airway.

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