Mode of delivery and lung function of 16-19 year olds born at less than 29 weeks gestation

Abstract

Background: The mode of delivery has been shown to influence the early immune system of infants, possibly via the Galectin 3 and CD98 pathway. Little is known as to whether this may lead to long term differences in lung function of those born prematurely.

Aim: To determine if the lung function of young people born very prematurely differed according to mode of delivery.

Methods: 162 young people aged 16-19 years and born at less than 29 weeks were assessed. Measurements included spirometry, plethysmography, lung clearance index and a shuttle run test. Lung function was converted to z scores. Regression analysis was used to adjust for differences in birthweight, gestational age and birthweight z scores between the two groups.

Results: Small airway function was better in those vaginally delivered (FEF₇₅ -0.82, SD 1.30 versus -1.78, SD 1.17, p=0.009). Other markers of airway function were also better (FEF₅₀ -0.82, SD 1.10 versus -1.22, SD 0.96, p=0.008), (FEF₂₅ -0.45, SD 1.68 versus -0.88, SD 1.10, p=0.013), FEF_25-75 -1.24, SD 1.31 versus -1.78, SD 1.17, p=0.003), (LCI 9.04, SD 1.06 versus 9.72, SD 1.64, p=0.41. FEV₁ was not statistically significantly different (-0.86, SD 1.29 versus -1.22, SD 1.35, p=0.059). Lung volumes (FVC -0.21, SD 1.28 versus -0.27, SD 1.44, p=0.670) FRC_pleth 0.46, SD 1.30 versus 0.90, SD 1.44, p=0.307 and exercise capacity were also not significantly different (1094m, SD 266 versus 1043, SD 214, p=0.221).

Conclusion: Vaginally delivered, very prematurely born young people had superior airway function.