Lung trajectories into adulthood of preterm born survivors and the influence of sex

Dinh Son Bui; Cassidy Du Berry; Nur Sabrina Idrose; Jeanie L Y Cheong; Shyamali Dharmage

doi:10.1016/j.prrv.2025.12.001

Lung trajectories into adulthood of preterm born survivors and the influence of sex

Paediatr Respir Rev. 2025 Dec 24:S1526-0542(25)00109-5. doi: 10.1016/j.prrv.2025.12.001. Online ahead of print.

Authors

Dinh Son Bui¹, Cassidy Du Berry², Nur Sabrina Idrose³, Jeanie L Y Cheong⁴, Shyamali Dharmage³

Affiliations

¹ School of Population and Global Health, the University of Melbourne, Victoria, Australia. Electronic address: dinh.bui@unimelb.edu.au.
² Respiratory Research@Alfred, Monash University, Victoria, Australia; Respiratory Group, Murdoch Children's Research Institute, Victoria, Australia; Department of Paediatrics, the University of Melbourne, Victoria, Australia; Department of Respiratory and Sleep Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia.
³ School of Population and Global Health, the University of Melbourne, Victoria, Australia.
⁴ Newborn Services, The Royal Women's Hospital Melbourne, Victoria, Australia; Infant Brain Studies group, Murdoch Children's Research Institute, Victoria, Australia; Dept of Obstetrics, Gynaecology, and Newborn Health, University of Melbourne, Victoria, Australia; Department of Paediatrics, the University of Melbourne, Victoria, Australia.

PMID: 41521090
DOI: 10.1016/j.prrv.2025.12.001

Abstract

Preterm birth is increasingly recognised as a major determinant of lifelong respiratory health. Longitudinal studies consistently demonstrate that individuals born preterm have persistently worse lung function from childhood to adulthood compared with their term born peers. These adverse effects vary across gestational categories including extremely preterm, very preterm and moderate-late preterm birth, and are further exacerbated by bronchopulmonary dysplasia (BPD). Pooled analyses show that children or adults born preterm without BPD had 7.2% [95 confidence interval (CI): 5.6-8.7%] lower percent predicted FEV₁ than term-born individuals. The %FEV₁ deficit was greater in those with BPD: 18.9% [16.7-21.1%] lower for the BPD₃₆ group when compared with the term born group. Lung function deficits in pre-term born survivors persist into adult life. Preterm birth is also associated with increased risk of COPD in later life. There is evidence that male sex confers additional vulnerability in pre-term survivors, with recent literature showing poorer lung function in males compared with females. Understanding these relationships is central to developing future phenotyping frameworks, enabling early identification of those at greatest risk, and informing surveillance strategies aimed at preserving lung function and preventing early onset of chronic obstructive pulmonary disease.

Keywords: Bronchopulmonary dysplasia; Differential gender outcomes; Lung function trajectories; Preterm delivery.

Publication types

Review