Very prematurely born infants wheezing at follow-up: lung function and risk factors
- Simon Broughton1,
- Mark R Thomas1,
- Louise Marston2,
- Sandra A Calvert3,
- Neil Marlow4,
- Janet L Peacock2,
- Gerrard F Rafferty1,
- Anne Greenough1
- 1MRC-Asthma Centre, Division of Asthma, Allergy and Lung Biology, King’s College London, London, UK
- 2School of Health Sciences and Social Care, Brunel University, London, UK
- 3Department of Child Health, St George’s Hospital Medical School, London, UK
- 4Academic Division of Child Health, School of Human Development, University of Nottingham, Nottingham, UK
- Professor Anne Greenough, 4th Floor, Golden Jubilee Wing, King’s College Hospital, Denmark Hill, London SE5 9RS, UK;
- Accepted 26 March 2007
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.
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.
- 95% CI
- 95% confidence intervals
- bronchopulmonary dysplasia
- functional residual capacity
- odds ratio
- post-menstrual age
- respiratory syncytial virus
- small for gestational age