RT Journal Article
SR Electronic
T1 Better respiratory outcomes for extremely preterm born children
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA4763
DO 10.1183/13993003.congress-2015.OA4763
VO 46
IS suppl 59
A1 Engeseth, Merete S.
A1 Clemm, Hege
A1 Røksund, Ola
A1 Øymar, Knut
A1 Markestad, Trond
A1 Halvorsen, Thomas
A1 Vollsæter, Maria
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/OA4763.abstract
AB Introduction: Impaired pulmonary function (PF) is reported after extremely preterm (EP) birth. Better perinatal management facilitates survival of more immature infants, potentially influencing outcomes.Aim: Compare PF in two cohorts of EP-born.Methods: Two population-based cohorts of EP and term-born subjects born in Western Norway in 1991-92 (35 EP-born, 35 term-born) and 1999-2000 (57 EP-born, 54 term-born) were compared. Inclusion criteria were BW<1000 g vs. <1001 g and gestational age (GA)<28 weeks vs. <29 weeks in 1999-2000 and 1991-92, respectively. EP-born were split by bronchopulmonary dysplasia (BPD), defined as oxygen supplementation at GA 36 weeks. PF were examined at age 10-11 years.Results: Mean survival after admittance to neonatal intensive care was 81% in 1999-2000 vs. 76% in 1991-92 (p=0.57). Mean PF-difference between term and EP-born with BPD was lower in 1999-2000 vs. 1991-92, z-FEV1 (0.43 vs. 1.46;p=0.02), z-FVC (0.01 vs. 0.51;p<0.001), z-FEV1/FVC (0.62 vs. 1.51;p=0.03), z-FEF25-75% (0.72 vs. 1.72;p=0.04), z-RV (0.31 vs. -0.79;p=0.02) and RV/TLC (1.0 vs. -5.8;p=0.03). The z-FEV1- difference disappeared with adjustment for antenatal steroids and surfactant administration, both administered more frequently in 1999-2000. In 1999-2000, z-BW was the only predictor of z-FEV1 (B=0.24;p=0.04;R2=0.10), in 1991-92 z-BW (B=0.35;p=0.02) predicted z-FEV1 also with days of oxygen (B=-0.011;p<0.001) and antenatal corticosteroids (B=0.59;p=0.03) (R2=0.48).Conclusion: PF was better for EP-born in 1999-2000 compared to 1991-92, particularly in those with BPD. The findings suggest better neonatal care leads to better pulmonary outcomes, despite increased survival of immature infants.