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


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.

  • lung function
  • prematurity
  • wheeze

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    BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health