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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