Background Preterm birth and maternal gestational disorders may adversely impact the pulmonary health of offspring.
Aims To examine whether exposure to common conditions during fetal-life (preterm birth, gestational hypertension, gestational diabetes) predicts poorer lung function in young adults.
Methods The ESTER study is a case-control cohort study of individuals born in Northern Finland 1985–89. Study design has two parts: 1) preterm birth included 139 early preterm (<34 weeks) and 239 late preterm (34- <37 weeks) birth subjects; 2) maternal pregnancy disorder included 154 subjects exposed to maternal gestational diabetes (GDM), 136 to pre-eclampsia (PE) and 179 to gestational hypertension (GH). Control group sizes varied. At mean age of 23.5y (±1.7), participants underwent a detailed clinical study including spirometric measurement of FVC, FEV1 and FEV/FVC%, as % from predicted.
Results Participants born preterm had similar FVC but poorer airflow than term-born. This difference was seen among early and late preterm births (Table1), although for the late preterm, significant only in preliminary models.
Lung function in individuals exposed to PE was lower, but this difference disappeared by adjusting for gestational length. Maternal GH or GDM were unrelated to lung function (Table 2).
Conclusion Shorter gestation and fetal-life conditions are likely to have long-lasting impacts on lung function: preterm-born individuals are likely to experience increased airway obstruction. Even late preterm birth (majority of preterm births), can increase the risk of poor pulmonary outcome. Preeclampsia may have similar effects, adding to the fetal origins of poor pulmonary health. This could be counterbalanced by physical excercise.
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