Lung function and respiratory health in adolescents of very low birth weight
Lung function and respiratory health in adolescents of very low birth weight
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DOI：
10.1136/adc.88.2.135
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发表时间：
2003-02-01
影响因子：
5.2
通讯作者：
Pharoah, POD
中科院分区：
文献类型：
--
作者：
Anand, D;Stevenson, CJ;Pharoah, POD
目的：确定极低出生体重（VLBW；出生体重< 1500 g）是否与青春期肺功能和呼吸健康下降有关，如果是，这种损害是否与早产或宫内生长受限有关。方法：对1980/81年出生的128名VLBW婴儿和年龄、性别、学校相匹配的对照组进行研究。队列和对照组在15岁时进行评估。测定指标病例的出生体重比（妊娠期观察出生体重/预期出生体重），以评估生长受限程度。新生儿期间接受的呼吸支持从医院记录中获得。通过问卷调查了解吸烟习惯和呼吸系统发病率。使用便携式肺活量计测量用力肺活量（FVC）、1秒用力呼气量（FEV1）和用力呼气流量（FVC 25-75%）。这些值以使用标准参考值预测的身高、年龄和性别的百分比表示。根据母亲和孩子的吸烟习惯进行了调整。结果：FEF25-75% （-12.42%, p < 0.001）和FEV1/FVC （-3.53%, p < 0.001）比值在指数组与对照组之间的平均值差异均有统计学意义。FVC和FEV1差异无统计学意义。在指标队列中未发现出生体重比与肺功能之间的相关性。慢性咳嗽、喘息和哮喘在指数组中比对照组更常见。在指数组中，接受和未接受呼吸支持的患者的肺功能没有差异。结论：与对照组相比，VLBW青少年出现中、小气道阻塞。这与早产有关，而不是宫内生长受限或在新生儿期接受呼吸支持。与对照组相比，指数VLBW组也更容易出现慢性咳嗽、喘息和哮喘。
Aims: To determine if very low birth weight (VLBW; birth weight < 1500 g) is associated with reduced lung function and respiratory health in adolescence and, if it is, whether this impairment is associated with prematurity or intrauterine growth restriction.Methods: A geographically defined cohort of 128 VLBW infants and an age, sex, and school matched comparison group born in 1980/81 were studied. The cohort and comparison group were assessed at 15 years of age. The birth weight ratio of the index cases (observed birth weight/expected birth weight for the gestation) was determined to assess the degree of growth restriction. Respiratory support received during the neonatal period was obtained from hospital records. Smoking habits and respiratory morbidity were obtained through questionnaires. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory flow when 25-75% of FVC is expired (FEF25-75%) were measured using a portable spirometer. The values are expressed as percentage predicted for height, age, and gender using standard reference values. Adjustments were made for smoking habits of mother and children.Results: The differences in means between index and comparison groups for FEF25-75% (-12.42%; p < 0.001) and FEV1/FVC (-3.53%; p < 0.001) ratio were statistically significant. The differences in FVC and FEV1 were not significant. No correlation was found between the birth weight ratio and lung function among the index cohort. Chronic cough, wheezing, and asthma were more common among the index cohort than in the comparison group. Within the index group, there was no difference in lung function between those who received and those who did not receive respiratory support.Conclusion: Adolescents who were VLBW compared with matched controls showed medium and small airways obstruction. This was associated with prematurity rather than intrauterine growth restriction or having received respiratory support during the neonatal period. The index VLBW cohort compared with their controls were also more prone to chronic cough, wheezing, and asthma.