Lung function development after preterm birth in relation to severity of Bronchopulmonary dysplasia

BMC Pulm Med. 2017 Jun 30;17(1):97. doi: 10.1186/s12890-017-0441-3.


Background: Bronchopulmonary dysplasia (BPD) is a strong risk factor for respiratory morbidity in children born preterm. Our aims were to evaluate lung function in adolescents born preterm with and without a history of BPD, and to assess lung function change over time from school age.

Methods: Fifty-one individuals born in Stockholm, Sweden between gestational ages 24 to 31 weeks (23 neonatally diagnosed with respiratory distress syndrome (RDS) but not BPD, and 28 graded as mild (n = 17), moderate (n = 7) or severe (n = 4) BPD) were examined in adolescence (13-17 years of age) using spirometry, impulse oscillometry (IOS), plethysmography, and ergospirometry. Comparison with lung function data from school age (6-8 years of age) was also performed.

Results: Adolescents with a history of BPD had lower forced expiratory volume in 1 s (FEV1) compared to those without BPD (-0.61 vs.-0.02 z-scores, P < 0.05), with lower FEV1 values significantly associated with BPD severity (P for trend 0.002). Subjects with severe BPD had higher frequency dependence of resistance, R5-20, (P < 0.001 vs. non-BPD subjects) which is an IOS indicator of peripheral airway involvement. Between school age and adolescence, FEV1/FVC z-scores decreased in all groups and particularly in the severe BPD group (from -1.68 z-scores at 6-8 years to -2.74 z-scores at 13-17 years, p < 0.05 compared to the non-BPD group).

Conclusions: Our results of spirometry and IOS measures in the BPD groups compared to the non-BPD group suggest airway obstruction including involvement of peripheral airways. The longitudinal result of a decrease in FEV1/FVC in the group with severe BPD might implicate a route towards chronic airway obstruction in adulthood.

Keywords: Adolescents; Bronchopulmonary dysplasia; Ergospirometry; Lung function tests; Oscillometry; Spirometry.

MeSH terms

  • Adolescent
  • Bronchopulmonary Dysplasia / physiopathology*
  • Child
  • Exercise Test
  • Exercise Tolerance
  • Female
  • Forced Expiratory Volume
  • Humans
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Oscillometry
  • Oxygen Consumption
  • Plethysmography
  • Premature Birth / physiopathology*
  • Respiratory Distress Syndrome, Newborn / physiopathology*
  • Severity of Illness Index
  • Spirometry
  • Vital Capacity