Lung function among infants born preterm, with or without bronchopulmonary dysplasia

Abstract

OBJECTIVE: Both healthy preterm infants and those with bronchopulmonary dysplasia (BPD) have poor lung function during childhood and adolescence, although there is no evidence whether prematurity alone explains the reduction in lung function found in BPD infants. Our study seeks to know if lung function, measured in infancy by means of rapid thoracic compression with raised volume technique, is different between preterm infants with and without BPD. METHODS: Lung function was measured in 43 preterm infants with BPD and in 32 preterm infants without BPD at a chronological age range of 2-28 months. Forced vital capacity (FVC), forced expiratory volume at 0.5 sec, and forced expiratory flows at 50, 75, 85%, and 25-75% of FVC were obtained from maximal expiratory volume curves by means of rapid thoracic compression with raised volume technique. Maximal flow at functional residual capacity was measured using rapid thoracic compression at tidal volume. Multiple regression analysis and generalized least squares (GLS) random-effects regression model were used to control for variables such as gender, weeks of gestation, age, birth weight, and tobacco smoke exposure. A sub-analysis was performed in infants born at 28+ weeks of gestation. RESULTS: BPD was associated to significantly lower flows (regression coefficients: -0.51, -0.54, -57, -0.53, and -0.82, respectively for FEF(50), FEF(75), FEF(85), FEF(25-75)). This association was driven by males and maintained in the subgroup of infants born at 28+ weeks of gestation. CONCLUSION: BPD is associated with an additional decrease of lung function during the first 2 years of life in infants born preterm.