Lung function and respiratory health in adolescents of very low birth weight

[Guest guest]

Subject: Lung function and respiratory health in adolescents of very low

birth weight

Archives of Disease in Childhood 2003;88:135-138

2003 BMJ Publishing Group & Royal College of Paediatrics and Child Health

ORIGINAL ARTICLE

Lung function and respiratory health in adolescents of very low birth weight

D Anand, C J son, C R West and P O D Pharoah FSID Unit of Perinatal

and Paediatric Epidemiology, Department of Public Health, Liverpool, UK

Correspondence to:

Dr D Anand, FSID Unit of Perinatal and Paediatric Epidemiology,

Department of Public Health, Muspratt Building, Liverpool L69 3GB, UK;

anand@...

Aims: To determine if very low birth weight (VLBW;

birth weight <1500 g) is associated with reduced lung function and

respiratory health in adolescence and, if it is, whether this impairment

is associated with prematurity or intrauterine growth restriction.

Methods: A geographically defined cohort of 128 VLBW infants and an age,

sex, and school matched comparison group born in 1980/81 were studied.

The cohort and comparison group were assessed at 15 years of age. The

birth weight ratio of the index cases (observed birth weight/expected

birth weight for the gestation) was determined to assess the degree of

growth restriction. Respiratory support received during the neonatal

period was obtained from hospital records. Smoking habits and respiratory

morbidity were obtained through questionnaires. Forced vital capacity

(FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory

flow when 25?75% of FVC is expired (FEF25?75%) were measured using a

portable spirometer. The values are expressed as percentage predicted for

height, age, and gender using standard reference values. Adjustments were

made for smoking habits of mother and children. Results: The differences

in means between index and comparison groups for FEF25?75% (-12.42%; p <

0.001) and FEV1/FVC (-3.53%; p < 0.001) ratio were statistically

significant. The differences in FVC and FEV1 were not significant. No

correlation was found between the birth weight ratio and lung function

among the index cohort. Chronic cough, wheezing, and asthma were more

common among the index cohort than in the comparison group. Within the

index group, there was no difference in lung function between those who

received and those who did not receive respiratory support. Conclusion:

Adolescents who were VLBW compared with matched controls showed medium

and small airways obstruction. This was associated with prematurity

rather than intrauterine growth restriction or having received

respiratory support during the neonatal period. The index VLBW cohort

compared with their controls were also more prone to chronic cough,

wheezing, and asthma.