Respiratory health in pre-school and school age children following extremely preterm birth
Epicure Study Grp (Including: Hennessy, Enid M., Bracewell, Melanie A., Wood, N., Wolke, Dieter, Costeloe, Kate, Gibson, Alan, MB BS and Marlow, Neil). (2008) Respiratory health in pre-school and school age children following extremely preterm birth. Archives of Disease in Childhood, Vol.93 (No.12). pp. 1037-1043. ISSN 0003-9888Full text not available from this repository.
Official URL: http://dx.doi.org/10.1136/adc.2008.140830
Rationale: Increasing survival at extremely low gestational ages is associated with very high rates of bronchopulmonary dysplasia (BPD) but is rarely quantified. Objectives: To identify respiratory morbidity and risk factors in the EPICure cohort over the first 6 years of life. Methods: 308 babies born at (25 weeks' gestation in 1995 were followed up at 30 months and 6 years of age. Respiratory outcome was evaluated using clinical assessment, parental questionnaire and peak expiratory flow (PEF) at 6 years. Results: 74% of this population received supplemental oxygen at 36 weeks postmenstrual age and 36% were discharged with supplemental oxygen which continued for a median of 2.5 months (75th percentile: 8.5 months). 236 children were followed to 6 years. Respiratory symptoms and medication use were more prevalent at 30 months and 6 years in children with BPD compared to those without. Children without BPD (n = 56) were not significantly different from their classmates but had consistently higher prevalence of poor respiratory health. Symptoms, need for hospital admission and medication use declined between 30 months and 6 years. 200 index children completed three PEF measures; PEF was lower than in classmates (mean adjusted difference: 39 l/min (95% CI 30 to 47)) and was lowest in children discharged home with oxygen and in those with BPD. Gestational age, BPD and maternal smoking at home and in pregnancy were independent risk factors for symptoms, but BPD was the only independent associate of PEF. Conclusion: Extremely preterm children have a continuum of poor respiratory health over the first 6 years, which is exacerbated by smoking during pregnancy and in the home.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RC Internal medicine
R Medicine > RJ Pediatrics
|Divisions:||Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing
Faculty of Science > Psychology
|Library of Congress Subject Headings (LCSH):||Premature infants -- Development, Respiratory organs -- Diseases, Pediatric respiratory diseases|
|Journal or Publication Title:||Archives of Disease in Childhood|
|Number of Pages:||7|
|Page Range:||pp. 1037-1043|
|Funder:||BLISS, Health Foundation (Great Britain), WellBeing (Organization)|
|References:||1. Northway WH Jr. Bronchopulmonary dysplasia: then and now. Arch Dis Child 1990;65(10 Spec No):1076–81. 2. Coalson JJ. Pathology of new bronchopulmonary dysplasia. Semin Neonatol 2003;8:73–81. 3. Jobe AJ. The new BPD: an arrest of lung development. Pediatr Res 1999;46:641–3. 4. Anderson PJ, Doyle LW. Neurodevelopmental outcome of bronchopulmonary dysplasia. Semin Perinatol 2006;30:227–32. 5. Gray PH, O’Callaghan MJ, Rogers YM. Psychoeducational outcome at school age of preterm infants with bronchopulmonary dysplasia. J Paediatr Child Health 2004;40:114–20. 6. Costeloe K, Hennessy E, Gibson AT, et al. The EPICure Study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 2000;106:659–71. 7. Wood NS, Costeloe K, Gibson AT, et al. The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth. Arch Dis Child Fetal Neonatal Ed 2005;90:F134–40. 8. Wood NS, Marlow N, Costeloe K, et al. Neurologic and developmental disability after extremely preterm birth. EPICure Study Group. N Engl J Med 2000;343:378–84. 9. Wood NS, Costeloe K, Gibson AT, et al. The EPICure study: growth and associated problems in children born at 25 weeks of gestational age or less. Arch Dis Child Fetal Neonatal Ed 2003;88:F492–500. 10. Bhandari A, Panitch HB. Pulmonary outcomes in bronchopulmonary dysplasia. Semin Perinatol 2006;30:219–26. 11. Marlow N, Wolke D, Bracewell MA, et al. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005;352:9–19. 12. Marlow N, Hennessy E, Bracewell M, et al. Motor and executive function at 6 years of age following extremely preterm birth. Pediatrics 2007;120:793–804. 13. Asher MI, Keil U, Anderson HR, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 1995;8:483–91. 14. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723–9. 15. Chye JK, Gray PH. Rehospitalization and growth of infants with bronchopulmonary dysplasia: a matched control study. J Paediatr Child Health 1995;31:105–11. 16. Furman L, Baley J, Borawski-Clark E, et al. Hospitalization as a measure of morbidity among very low birth weight infants with chronic lung disease. J Pediatr 1996;128:447–52. 17. Greenough A. Measuring respiratory outcome. Semin Neonatol 2000;5:119–26. 18. Greenough A, Cox S, Alexander J, et al. Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child 2001;85:463–8. 19. Kitchen WH, Olinsky A, Doyle LW, et al. Respiratory health and lung function in 8- year-old children of very low birth weight: a cohort study. Pediatrics 1992;89(6 Pt 2):1151–8. 20. Doyle LW, Cheung MM, Ford GW, et al. Birth weight ,1501 g and respiratory health at age 14. Arch Dis Child 2001;84:40–4. 21. Northway WH Jr, Moss RB, Carlisle KB, et al. Late pulmonary sequelae of bronchopulmonary dysplasia. N Engl J Med 1990;323:1793–9. 22. Doyle LW, Faber B, Callanan C, et al. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics 2006;118:108–13. 23. Halvorsen T, Skadberg BT, Eide GE, et al. Pulmonary outcome in adolescents of extreme preterm birth: a regional cohort study. Acta Paediatr 2004;93:1294–300. 24. Vrijlandt EJLE, Boezen HM, Gerritsen J, et al. Respiratory health in prematurely born preschool children with and without bronchopulmonary dysplasia. J Pediatr 2007;150:256–61. 25. Coalson JJ, Winter V, deLemos RA. Decreased alveolarization in baboon survivors with bronchopulmonary dysplasia. Am J Respir Crit Care Med 1995;152:640–6. 26. Askie LM, Henderson-Smart DJ, Irwig L, et al. Oxygen-saturation targets and outcomes in extremely preterm infants. N Engl J Med 2003;349:959–67. 27. Chan KN, Silverman M. Neonatal chronic lung disease and a family history of asthma. Pediatr Pulmonol 1995;20:273–5. 28. Doyle LW, Victorian Infant Collaborative Study Group. Respiratory function at age 8– 9 years in extremely low birthweight/very preterm children born in Victoria in 1991– 1992. Pediatr Pulmonol 2006;41:570–6.|
Actions (login required)