ABSTRACT
OBJECTIVES: The purpose of this work was to determine the relationship between lung function in late adolescence and bronchopulmonary dysplasia, to establish whether lung function changed more from earlier in childhood in those with bronchopulmonary dysplasia, and to assess the effect of different definitions of bronchopulmonary dysplasia on respiratory outcome. METHODS: Subjects were composed of 147 survivors of birth weight <1500 g from the Royal Women's Hospital (Melbourne, Australia) born during 1977-1982 and who had lung function tests at a mean age of 18.9 years. Of the 147 subjects, 33 (22%) had bronchopulmonary dysplasia in the newborn period. Lung function was measured according to American Thoracic Society guidelines. RESULTS: All of the lung function variables reflecting airflow were substantially diminished in the bronchopulmonary dysplasia group, but lung volumes were not significantly different. More subjects in the bronchopulmonary dysplasia group had reductions in airflow in the clinically significant range (eg, forced expired volume in 1 second/forced vital capacity ratio <75%; bronchopulmonary dysplasia: 42.4% [14 of 33]; and no bronchopulmonary dysplasia: 16.4% [18/114]). Results were not substantially affected after adjustment for confounding variables, including intrauterine growth restriction or birth weight. Compared with earlier in childhood, the forced expired volume in 1 second/forced vital capacity ratio deteriorated more in bronchopulmonary dysplasia subjects between 8 and 18 years. Lung function results varied little with different definitions of bronchopulmonary dysplasia. CONCLUSIONS: Subjects of very low birth weight with bronchopulmonary dysplasia in the newborn period have poorer lung function in late adolescence than those without bronchopulmonary dysplasia, and their lung function may be deteriorating at a more rapid rate.
Subject(s)
Bronchopulmonary Dysplasia/epidemiology , Bronchopulmonary Dysplasia/physiopathology , Infant, Very Low Birth Weight , Adult , Age Factors , Birth Weight , Female , Follow-Up Studies , Forced Expiratory Volume , Humans , Infant, Newborn , Male , Respiratory Function Tests , Vital CapacityABSTRACT
OBJECTIVE: To determine whether active smoking has an adverse impact on respiratory function of young adults of extremely low birth weight (ELBW; birth weight <1000 g). METHODS: This was a cohort study of 60 consecutive ELBW survivors who were born during 1977-1980 at Royal Women's Hospital, Melbourne, Australia. Respiratory function was measured on 44 (73%) of the subjects at a mean age of 20.2 years (standard deviation: 1.0 year). Respiratory function had also been measured on 42 of the 44 subjects at 8 years of age. Respiratory function was compared between the 14 smokers and the 30 nonsmokers. RESULTS: Several respiratory function variables reflecting airflow (the forced expired volume in 1 second [FEV(1)]/forced vital capacity [FVC] ratio; flow rates at 75%, 50%, and 25% of vital capacity; and mid-expiratory flow from 25% to 75% of vital capacity) were significantly diminished in smokers. The proportion with a clinically important reduction in the FEV(1)/FVC ratio (<75%) was significantly higher in smokers (64%) than in nonsmokers (20%). There was a significantly larger decrease in the FEV(1)/FVC ratio between ages 8 and 20 years in the smokers (mean change: -8.2%; 95% confidence interval: -14.1% to -2.4%) CONCLUSIONS: Active smoking by young adult survivors of ELBW is associated with reduced respiratory function.
Subject(s)
Infant, Very Low Birth Weight , Respiratory System/drug effects , Respiratory System/physiopathology , Smoking/adverse effects , Smoking/physiopathology , Adult , Cohort Studies , Female , Humans , Infant, Newborn , Male , Respiratory Function Tests/methodsABSTRACT
OBJECTIVES: To determine whether blood pressure (BP) differed between very low birth weight (VLBW; birth weight