RT Journal Article
SR Electronic
T1 Perinatal factors associated with long-term respiratory sequelae in extremely low birthweight infants
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F314
OP F319
DO 10.1136/archdischild-2014-306931
VO 100
IS 4
A1 Katsuya Hirata
A1 Masahiro Nishihara
A1 Jun Shiraishi
A1 Shinya Hirano
A1 Katsura Matsunami
A1 Kiyoaki Sumi
A1 Norihisa Wada
A1 Yutaka Kawamoto
A1 Masanori Nishikawa
A1 Masahiro Nakayama
A1 Tadahiro Kanazawa
A1 Hiroyuki Kitajima
A1 Masanori Fujimura
YR 2015
UL http://fn.bmj.com/content/100/4/F314.abstract
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.