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Paediatric lung disease
Original research
Tracking of lung function from 10 to 35 years after being born extremely preterm or with extremely low birth weight
  1. Tonje Bårdsen1,2,
  2. Ola Drange Røksund1,3,4,
  3. Merete Røineland Benestad1,5,
  4. Karl Ove Hufthammer6,
  5. Hege Havstad Clemm1,2,
  6. Ingvild Bruun Mikalsen2,7,
  7. Knut Øymar2,7,
  8. Trond Markestad2,
  9. Thomas Halvorsen1,2,
  10. Maria Vollsæter1,2
  1. 1 Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
  2. 2 Department of Clinical Science, University of Bergen, Bergen, Norway
  3. 3 Western Norway University of Applied Sciences Faculty of Health and Social Sciences, Bergen, Norway
  4. 4 Department of Head and Neck surgery, ENT, Haukeland University Hospital, Bergen, Norway
  5. 5 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  6. 6 Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
  7. 7 Stavanger University Hospital, Stavanger, Norway
  1. Correspondence to Dr Maria Vollsæter, Department of Pediatrics, Haukeland University Hospital, Bergen, Norway; maria.vollseter{at}helse-bergen.no

Abstract

Background Lifelong pulmonary consequences of being born extremely preterm or with extremely low birth weight remain unknown. We aimed to describe lung function trajectories from 10 to 35 years of age for individuals born extremely preterm, and address potential cohort effects over a period that encompassed major changes in perinatal care.

Methods We performed repeated spirometry in three population-based cohorts born at gestational age ≤28 weeks or with birth weight ≤1000 g during 1982–85, 1991–92 and 1999–2000, referred to as extremely preterm-born, and in term-born controls matched for age and gender. Examinations were performed at 10, 18, 25 and 35 years. Longitudinal data were analysed using mixed models regression, with the extremely preterm-born stratified by bronchopulmonary dysplasia (BPD).

Results We recruited 148/174 (85%) eligible extremely preterm-born and 138 term-born. Compared with term-born, the extremely preterm-born had lower z-scores for forced expiratory volume in 1 s (FEV1) at most assessments, the main exceptions were in the groups without BPD in the two youngest cohorts. FEV1 trajectories were largely parallel for the extremely preterm- and term-born, also during the period 25–35 years that includes the onset of the age-related decline in lung function. Extremely preterm-born had lower peak lung function than term-born, but z-FEV1 values improved for each consecutive decade of birth (p=0.009). More extremely preterm—than term-born fulfilled the spirometry criteria for chronic obstructive pulmonary disease, 44/148 (30%) vs 7/138 (5%), p<0.001.

Conclusions Lung function after extremely preterm birth tracked in parallel, but significantly below the trajectories of term-born from 10 to 35 years, including the incipient age-related decline from 25 to 35 years. The deficits versus term-born decreased with each decade of birth from 1980 to 2000.

  • lung physiology
  • COPD epidemiology
  • clinical epidemiology
  • health economist
  • paediatric lung disaese

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/thoraxjnl-2021-218400

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Contributors TB drafted the manuscript, prepared figure 1 and contributed to data collection, quality control, figure preparation and statistical analysis. ODR was responsible for quality control and contributed to data collection. KOH performed the statistical analysis, wrote the statistical methods section and prepared the figures 2 and 3. MRB, HHC, IBM and KØ contributed to data collection. TM contributed to the design of the study, data collection, and quality control. MV and TH had intellectual oversight of the project, designed the study and contributed to manuscript drafting, data collection and quality control. All authors contributed to the writing and critical review of the manuscript, and approved the final version. MV is responsible for the overall content as the guarantor.

    • Funding Western Norway Regional Health Authority.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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