Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era
Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era
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DOI：
10.1136/thoraxjnl-2016-208524
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发表时间：
2017-08-01
期刊：
影响因子：
10
通讯作者：
Cheong, Jeanie L.
中科院分区：
文献类型：
--
作者：
Doyle, Lex W.;Adams, Anne-Marie;Cheong, Jeanie L.
研究背景极早产儿气道阻塞在青春期后期的发展（胎龄<28周）或极低出生体重（出生体重<1000 g）存活者在引入表面活性剂后的时代尚不清楚。目的比较早产存活者与正常出生体重对照的地理队列从8岁到18岁的肺量计变化，并确定在早产cohol.Methods的297极早产/低出生体重的幸存者在1991 - 1992年出生在澳大利亚的维多利亚州，81%和70%的肺功能测定在8和18岁，分别。在260名正常出生体重对照组中，对应率分别为80%和58%。结果与对照组相比，早产儿组在两个年龄段的气流都有明显的损害（例如，FEV1的z评分的平均差异; 8岁时-1.02，95%CI-1.21至-0.82; 18岁时-0.92，95%CI-1.14至-0.71）。与对照组相比，早产儿组在8至18岁之间的小气道阻塞增加更大。早产儿组内，那些谁在新生儿期和那些谁是吸烟者在18岁的气道阻塞，随着时间的推移增加与那些谁没有。结论出生在表面活性剂时代的早产儿幸存者有显着的损害，通过儿童到青春期后期的气流，随着时间的推移增加与对照组相比。有风险的早产儿参与者包括那些患有支气管肺发育不良的人和18岁时的吸烟者。
Background The evolution of airway obstruction into late adolescence of extremely preterm (gestational age < 28 weeks) or extremely low-birthweight (birth weight < 1000 g) survivors in the era after surfactant was introduced is unclear.Objective To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort.Methods Of 297 extremely preterm/low-birth-weight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80% and 58%, respectively. Data were analysed using linear mixed models.Results The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95% CI -1.21 to -0.82; 18 years -0.92, 95% CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not.Conclusions Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.