Effect of preterm birth on exercise capacity: A systematic review and meta‐analysis. Issue 3 (27th October 2014)

• Record Type: Journal Article
• Authors: Edwards, Martin O.; Kotecha, Sarah J.; Lowe, John; Watkins, W. John; Henderson, A. John; Kotecha, Sailesh
• Is Part Of: Pediatric pulmonology. Volume 50:Issue 3(2015:Mar.)
• Page Start: 293
• Page End: 301
• Publication Date: 2014-10-27
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.23117
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>SUMMARY</title> <sec id="ppul23117-sec-0001" sec-type="section"> <title>Background</title> <p>Survivors of preterm‐birth have increased prevalence of respiratory, cardiovascular, and neurological diseases in later life however, the overall impact of prematurity on cardiorespiratory exercise capacity is unclear.</p> </sec> <sec id="ppul23117-sec-0002" sec-type="section"> <title>Objective</title> <p>We, therefore, systematically reviewed the literature on cardiorespiratory exercise capacity in survivors of preterm birth.</p> </sec> <sec id="ppul23117-sec-0003" sec-type="section"> <title>Methodology</title> <p>Relevant studies up to March 2013 were searched using eight electronic health databases. Studies reporting exercise capacity in participants born preterm (<37 weeks) were included. The main outcome of interest was oxygen uptake (<inline-formula><alternatives><inline-graphic mimetype="image" xlink:href="ark:/27927/pgh3xrsm4h1" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink" /><mml:math altimg="urn:x-wiley:14381656:media:ppul23117:ppul23117-math-0001" display="inline" overflow="scroll" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mi mathvariant="normal">V</mml:mi></mml:mrow><mml:mrow><mml:mo>˙</mml:mo></mml:mrow></mml:mover><mml:msub><mml:mrow><mml:mi mathvariant="normal">O</mml:mi></mml:mrow><mml:mrow><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi mathvariant="normal">max</mml:mi><mml:mo>⁡</mml:mo></mml:mrow></mml:math></alternatives></inline-formula>) at maximal exercise. Data were categorized into four groups: (i) preterm‐born subjects including those with or without bronchopulmonary dysplasia (BPD) but excluding study groups biased towards BPD; (ii) preterm‐born subjects (BPD excluded); (iii) preterm‐born subjects who had BPD<sub>28</sub> (defined as oxygen dependency at 28 days of life) in infancy; (iv) preterm born subjects with BPD<sub>36</sub> (oxygen dependency at 36 weeks post menstrual age) in infancy.</p> </sec> <sec id="ppul23117-sec-0004" sec-type="section"> <title>Results</title> <p>From 9, 341 abstracts, 22 included publications reported <inline-formula><alternatives><inline-graphic mimetype="image" xlink:href="ark:/27927/pgh3xrsm4h1" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink" /><mml:math altimg="urn:x-wiley:14381656:media:ppul23117:ppul23117-math-0001" display="inline" overflow="scroll" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mi mathvariant="normal">V</mml:mi></mml:mrow><mml:mrow><mml:mo>˙</mml:mo></mml:mrow></mml:mover><mml:msub><mml:mrow><mml:mi mathvariant="normal">O</mml:mi></mml:mrow><mml:mrow><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi mathvariant="normal">max</mml:mi><mml:mo>⁡</mml:mo></mml:mrow></mml:math></alternatives></inline-formula> in ml/kg/min from 685 preterm and 680 term‐born subjects. Overall 20 studies reported results for preterm‐born subjects including BPD; 14 studies for the preterm group excluding BPD; 10 studies for the BPD<sub>28</sub> group; and 8 studies for BPD<sub>36</sub> group. The mean differences (95% CI) for the four groups were −2.20 (−3.70, −0.70) ml/kg/min; −2.26 (−4.44, −0.07 ml/kg/min; −3.04 (−5.48, −0.61) ml/kg/min, and −3.05 (−5.93, −0.18) ml/kg/min, respectively.</p> </sec> <sec id="ppul23117-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Despite marked deficits in spirometry, preterm‐born children have a marginally decreased <inline-formula><alternatives><inline-graphic mimetype="image" xlink:href="ark:/27927/pgh3xrsm4h1" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink" /><mml:math altimg="urn:x-wiley:14381656:media:ppul23117:ppul23117-math-0001" display="inline" overflow="scroll" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mover accent="true"><mml:mrow><mml:mi mathvariant="normal">V</mml:mi></mml:mrow><mml:mrow><mml:mo>˙</mml:mo></mml:mrow></mml:mover><mml:msub><mml:mrow><mml:mi mathvariant="normal">O</mml:mi></mml:mrow><mml:mrow><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi mathvariant="normal">max</mml:mi><mml:mo>⁡</mml:mo></mml:mrow></mml:math></alternatives></inline-formula>, which is unlikely to be of great clinical significance. <bold>Pediatr Pulmonol. 2015; 50:293–301.</bold> © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>