Predictors of pulmonary function at six years of age in infants with
bronchopulmonary dysplasia
Abstract
Rationale: Bronchopulmonary dysplasia (BPD) is a major complication of
premature birth and the most common cause of chronic lung disease in
infancy. Previous studies have shown that children with a history of BPD
have impaired lung function in childhood compared to their term
counterparts. However, little is known about potential modifiable
factors that alter lung function trajectories and subsequent respiratory
morbidity in this population. Objectives: To identify potential
modifiable risk factors for the development of impaired lung function in
patients with a history of prematurity and BPD. Methods: Growth
parameters (birth, 2yo, 6yo) and pulmonary function testing (6yo) were
retrospectively reviewed for subjects (n=598) recruited from an
outpatient BPD clinic who were born ≤36 weeks gestation and were ≥5
years of age. Results: Of the 598 recruited subjects, 88 (14.7%)
performed adequate pulmonary function testing at approximately six years
of age. The mean FEV1% predicted was 84.5% with lower values
associated with lower median household income, Nissen fundoplication,
and higher weight percentiles at 2yo. The mean FVC % predicted was
94.2% with lower values associated with higher amounts of oxygen
required at time of initial hospital discharge, Nissen fundoplication,
and higher weight percentiles at 2yo. Conclusions: Our study found that
children with BPD have different long-term pulmonary trajectories than
full-term controls. Supplemental oxygen, lower income, and Nissen
fundoplication at discharge were associated with lower lung function at
6 years of age. Prospective studies should focus on modifiable risk
factors that could minimize the impact of BPD on later lung function.