Abstract
Background: Postnatal steroids reduce the incidence of BPD in very prematurely born children, but studies of their impact on lung function in childhood have yielded conflicting results
Aims and objectives: To assess the influence of postnatal corticosteroids on lung function of very prematurely born children aged 11-14 years.
Methods: Lung function was assessed in 244 children (born median gestational age of 27+0 (23+6-28+6) weeks) at 12.5 (range 11.3-14.9) years. Airway function was assessed by measurement of forced expiratory flow at 75%, 50% and 25% of the expired vital capacity (FEF25, FEF50, FEF75), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). Lung volumes were assessed by forced vital capacity (FVC) and residual volume (RV) and functional residual capacity by plethysmography (FRCpleth).
Results: Airway function and the lung volumes of the 68 children who had been exposed to steroids differed significantly from those not exposed
| Steroid Exposure | ||||
| Lung Function | N | No | Yes | P value |
| FEF75 z score | 244 | -0.937 (0.89) | -1.442 (0.76) | <0.001 |
| FEF50 z score | 244 | -1.040 (0.87) | -1.691 (0.81) | <0.001 |
| FEF25 z score | 244 | -0.814 (0.89) | -1.490 (0.85) | <0.001 |
| FEF25-75 z score | 227 | -1.245 (1.02) | -2.016 (1.01) | <0.001 |
| FEV1 z score | 244 | -0.549 (0.97) | -1.371 (1.08) | <0.001 |
| FVC z score | 244 | -0.237 (0.91) | -0.699 (1.07) | 0.001 |
| FEV1:FVC z score | 244 | -1.166 (1.59) | -2.203 (2.04) | <0.001 |
| PEF % of predicted | 243 | 85.7 (15.0) | 77.4 (14.4) | <0.001 |
| RV z score | 207 | 0.149 (0.08) | 1.172 (0.22) | <0.001 |
| FRCpleth z score | 214 | -0.226 (0.09) | 0.325 (0.19) | 0.005 |
Data are expressed as the mean (SD)
Lung Function and Steroid Exposure
Conclusion: These results suggest postnatal corticosteroids have long term adverse effects on lung function in this population.
- Copyright ©the authors 2016
