Impact of ethnicity and extreme prematurity on infant pulmonary function. Issue 7 (30th September 2013)

• Record Type: Journal Article
• Authors: Hoo, Ah‐Fong; Gupta, Amit; Lum, Sooky; Costeloe, Kate L.; Huertas‐Ceballos, Angela; Marlow, Neil; Stocks, Janet
• Is Part Of: Pediatric pulmonology. Volume 49:Issue 7(2014:Jul.)
• Page Start: 679
• Page End: 687
• Publication Date: 2013-09-30
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.22882
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Summary</title> <sec id="ppul22882-sec-0001" sec-type="section"> <p>The impact of birth before 27 completed weeks of gestation on infant pulmonary function (PF) was explored in a multi‐ethnic population in comparison to more mature preterm controls (PTC) and healthy fullterm infants. Plethysmographic lung volume (FRC<sub>pleth</sub>) and forced expired volume (FEV<sub>0.5</sub>) were obtained at ∼12 months post‐term age in 52 extremely preterm (EP) infants (median [range] gestational age [GA]: 26 [23–27] weeks; 40% White mothers; 79% with BPD), 41 PTC (GA:35 [30–36] weeks; 37% White mothers) and 95 fullterm infants (GA:40 [37–42] weeks; 86% White mothers). Using reference equations based on identical equipment and techniques, results were expressed as <italic>z</italic>‐scores to adjust for age, sex and body size. FEV<sub>0.5</sub> was significantly lower in EP infants when compared with PTC (mean difference [95% CI]: −1.02[−1.60; −0.44] <italic>z</italic>‐scores, <italic>P</italic> < 0.001), as was forced vital capacity (FVC) but there were no significant differences in FRC<sub>pleth</sub> or FEV<sub>0.5</sub>/FVC ratio. FEV<sub>0.5</sub>, FVC, and FEV<sub>0.5</sub>/FVC were significantly lower in both preterm groups when compared with fullterm controls. On multivariable analyses of the combined preterm dataset: FEV<sub>0.5</sub> at ∼1 year was 0.11 [0.05; 0.17] <italic>z</italic>‐scores higher/week GA, and 1.28 (0.49; 2.08) <italic>z</italic>‐scores lower in EP infants with prior BPD. Among non‐white preterm infants, FEV<sub>0.5</sub> was 0.70 (0.17; 1.24) <italic>z</italic>‐scores lower, with similar reductions in FVC, such that there were no ethnic differences in FEV<sub>0.5</sub>/FVC. Similar ethnic differences were observed among fullterm infants. These results confirm the negative impact of preterm birth on subsequent lung development, especially following a diagnosis of BPD, and emphasize the importance of taking ethnic background into account when interpreting results during infancy as in older subjects. <bold>Pediatr Pulmonol. 2014; 49:679–687.</bold> © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>