Structural and functional respiratory abnormalities in a contemporary cohort of 9-11 year old children born very preterm

Karla Logie

    Research output: ThesisDoctoral Thesis

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    Abstract

    [Truncated abstract] Advances in neonatal care have shifted the pathophysiology of preterm birth and bronchopulmonary dysplasia (BPD) such that the impact of contemporaneous preterm birth on long-term respiratory health remains unclear. We aimed to quantify midchildhood respiratory function and structure in children born very preterm (≤ 32 weeks gestational age), regardless of neonatal BPD status. We investigated if these outcomes were associated with neonatal characteristics and respiratory symptoms. Lung structure was assessed using a modified low-dose chest computed tomography (CT) protocol and lung function assessed by tests of forced oscillation (FOT), static lung volumes, spirometry and gas transfer (DLCO). We studied 158 children in total, including 46 term controls and 112 preterm children born ≤ 32 weeks gestation with 69 children diagnosed with BPD during the neonatal period. All preterm children received neonatal care at King Edward Memorial Hospital, Perth. Neonatal demographics of gender, gestation, birth weight and durations of supplemental oxygen, and CPAP accurately represented the very preterm population born during this era, with only duration of mechanical ventilation (MV) higher in the study BPD group. Respiratory symptoms were more prevalent in preterm children than a local birth cohort sample, with similar prevalences of symptoms between the first year of life and at mid-childhood. We compared the preterm cohort to the term cohort for each lung function measurement, with further analysis according to BPD status. Lung volumes measurements revealed increased FRC, FRC/TLC (%) and LCI in the preterm cohort, but no differences in VC, TLC, RV or RV/TLC (%), with increased FRC also associated with use of asthma medications in the preceding 3 months. Analysis of BPD and Non-BPD subgroups revealed FRC/TLC (%) to be significantly higher in the BPD compared to term children with no other differences between term, Non-BPD or BPD groups...
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2012

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