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Arch Dis Child 92:776-780 doi:10.1136/adc.2006.112623
  • Original article

Very prematurely born infants wheezing at follow-up: lung function and risk factors

  1. Simon Broughton1,
  2. Mark R Thomas1,
  3. Louise Marston2,
  4. Sandra A Calvert3,
  5. Neil Marlow4,
  6. Janet L Peacock2,
  7. Gerrard F Rafferty1,
  8. Anne Greenough1
  1. 1
    MRC-Asthma Centre, Division of Asthma, Allergy and Lung Biology, King’s College London, London, UK
  2. 2
    School of Health Sciences and Social Care, Brunel University, London, UK
  3. 3
    Department of Child Health, St George’s Hospital Medical School, London, UK
  4. 4
    Academic Division of Child Health, School of Human Development, University of Nottingham, Nottingham, UK
  1. Professor Anne Greenough, 4th Floor, Golden Jubilee Wing, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; anne.greenough{at}kcl.ac.uk
  • Accepted 26 March 2007

Abstract

Objectives: To determine whether abnormalities of lung volume and/or airway function were associated with wheeze at follow-up in infants born very prematurely and to identify risk factors for wheeze.

Design: Lung function data obtained at 1 year of age were collated from two cohorts of infants recruited into the UKOS and an RSV study, respectively.

Setting: Infant pulmonary function laboratory.

Patients: 111 infants (mean gestational age 26.3 (SD 1.6) weeks).

Interventions: Lung function measurements at 1 year of age corrected for gestational age at birth. Diary cards and respiratory questionnaires were completed to document wheeze.

Main outcome measures: Functional residual capacity (FRCpleth and FRCHe), airways resistance (Raw), FRCHe:FRCpleth and tidal breathing parameters (TPTEF:TE).

Results: The 60 infants who wheezed at follow-up had significantly lower mean FRCHe, FRCHe:FRCpleth and TPTEF:TE, but higher mean Raw than the 51 without wheeze. Regression analysis demonstrated that gestational age, length at assessment, family history of atopy and a low FRCHe:FRCpleth were significantly associated with wheeze.

Conclusions: Wheeze at follow-up in very prematurely born infants is associated with gas trapping, suggesting abnormalities of the small airways.

Footnotes

  • Dr Mark Thomas and Mrs Louise Marston were supported by a grant from the MRC who supported the UKOS trial. Dr Broughton was supported by a peer reviewed grant from the WellChild Trust and Abbott Laboratories.

  • Competing interests: None.

  • Abbreviations:
    95% CI
    95% confidence intervals
    BPD
    bronchopulmonary dysplasia
    FRC
    functional residual capacity
    OR
    odds ratio
    PMA
    post-menstrual age
    RSV
    respiratory syncytial virus
    SGA
    small for gestational age