PT - JOURNAL ARTICLE AU - Katsuya Hirata AU - Masahiro Nishihara AU - Jun Shiraishi AU - Shinya Hirano AU - Katsura Matsunami AU - Kiyoaki Sumi AU - Norihisa Wada AU - Yutaka Kawamoto AU - Masanori Nishikawa AU - Masahiro Nakayama AU - Tadahiro Kanazawa AU - Hiroyuki Kitajima AU - Masanori Fujimura TI - Perinatal factors associated with long-term respiratory sequelae in extremely low birthweight infants AID - 10.1136/archdischild-2014-306931 DP - 2015 Jul 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F314--F319 VI - 100 IP - 4 4099 - http://fn.bmj.com/content/100/4/F314.short 4100 - http://fn.bmj.com/content/100/4/F314.full SO - Arch Dis Child Fetal Neonatal Ed2015 Jul 01; 100 AB - Objective To assess lung function at 8 years old in extremely low birthweight (ELBW) survivors and to identify perinatal determinants associated with impaired lung function.Design Retrospective cohort study.Setting Level III neonatal intensive care unit.Patients ELBW survivors born in 1990–2004 with available spirometry at 8 years old were studied. Children were excluded if they had a Wechsler Intelligence Scale for Children Third Edition full IQ <70.Main outcome measures Multivariate logistic regression analysis was used to identify perinatal determinants associated with airway obstruction (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <80%) at school age and the predictive power of potential determinants. Potential risk factors and predictors assessed in this study were gestational age, birth weight, small for gestational age, sex, chorioamnionitis, premature rupture of membranes, antenatal steroids, surfactant administration, respiratory distress syndrome, postnatal steroids, severe bronchopulmonary dysplasia and bubbly/cystic appearances of the lungs by X-ray during the neonatal period.Results Of 656 ELBW survivors, 301 (45.9%) had attended a school-age follow-up at 8 years old. A total of 201 eligible children completed the lung function test. Bubbly/cystic appearance of the lungs (OR 4.84, 95% CI 1.26 to 18.70) was associated with a low FEV1/FVC ratio. Children with bubbly/cystic appearance had characteristics of immaturity and intrauterine inflammation.Conclusions Within a cohort of ELBW infants, a bubbly/cystic appearance of the lungs in the neonatal period was the strongest determinant of a low FEV1/FVC ratio at school age.