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Neonatal bronchopulmonary dysplasia predicts abnormal pulmonary HRCT in long term survivors of extreme preterm birth
  1. Stein Magnus Aukland (stein.magnus.aukland{at}helse-bergen.no)
  1. Haukeland University Hospital and Section for Radiology , Department of Surgical Sciences, Unive, Norway
    1. Karen Rosendahl
    1. Department of Radiology, Great Ormond Street Hospital for Children, London, United Kingdom
      1. Catherine M Owens
      1. Department of Radiology, Great Ormond Street Hospital for Children, London, United Kingdom
        1. Kari Fosse
        1. Department of Radiology, Haukeland University Hospital, Bergen, Norway
          1. Geir Egil Eide
          1. Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
            1. Thomas Halvorsen
            1. Department of Pediatrics, Haukeland University Hospital, Bergen, Norway and Dep of Clin.Med, Norway

              Abstract

              Objectives: There is an increasing understanding that extreme preterm birth carries a risk of long-term pulmonary sequelae. We investigated if and in what way neonatal factors were associated with subsequent abnormalities on pulmonary high-resolution computed tomography (HRCT), and if pulmonary function was related to these abnormalities.

              Subjects and methods: HRCT and pulmonary function tests were performed less than two weeks apart in 74 (86%) of 86 eligible subjects, born at a gestational age ≤ 28 weeks or with birth weight ≤ 1000 grams within a defined area in Western Norway in 1982 - 85 (n = 42) or 1991-92 (n = 32). Mean age at examination was 18 and 10 years, respectively. HRCTs were interpreted by a paediatric radiologist blinded to clinical data, using a structured system allowing scores from 0 to 50.

              Results: Lung parenchymal abnormalities were demonstrated in 64 (86%) subjects, the median score (interquartile range) being 3.0 (1.75-5.0) points. Prolonged neonatal requirement for oxygen treatment predicted poor outcome, and an increase of 100 days increased the average HRCT score by 3.8 points (p < 0.001). There was also a positive association of the severity of pulmonary function abnormalities with the extent of HRCT abnormalities, exemplified by the relation between FEV1 and total HRCT score (β = - 0.090; p < 0.001).

              Conclusions: In area-based cohorts of long-term survivors of extremely preterm birth, prolonged neonatal requirements for oxygen treatment predicted subsequent structural abnormalities on HRCT and in pulmonary function, and these two outcome measures were interrelated.

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