RT Journal Article
SR Electronic
T1 Association of Early Life Factors with Prematurity-Associated Lung Disease: Prospective Cohort Study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2101766
DO 10.1183/13993003.01766-2021
A1 Kylie Hart
A1 Michael Cousins
A1 W John Watkins
A1 Sarah J Kotecha
A1 A John Henderson
A1 Sailesh Kotecha
YR 2021
UL http://erj.ersjournals.com/content/early/2021/09/29/13993003.01766-2021.abstract
AB Introduction Although bronchopulmonary dysplasia (BPD) is associated with lung function deficits in childhood, many who develop BPD have normal lung function in childhood, and many without BPD including those born at 33–34 weeks’ gestation, have lung dysfunction in childhood. Since the predictability of BPD for future lung deficits is increasingly doubted, we prospectively recruited preterm-born children to identify early life factors which are associated with lung function deficits after preterm-birth.Methods From 767 children aged 7–12 years, who had their respiratory symptoms assessed, and had spirometry before and after a bronchodilator in our Respiratory Health Outcomes in Neonates (RHiNO) study, 739 (544 preterm-born at ≤34 weeks’ gestation and 195 term-born) had satisfactory lung function. Data were analysed using multivariable logistic regression and mediation.Results When preterm-born children were classified according to their lung function, low lung function (prematurity-associated lung disease, PLD) was associated with BPD, gestation and intrauterine growth restriction on univariable logistic regression analyses. However, on multivariable logistic regression analyses, gestation (Beta=−0.153, se: 0.051, p=0.003) and intrauterine growth restriction (odds ratio 1.783, 95% confidence interval: 1.06, 3.00, p=0.029) remained significantly associated with later deficits of lung function but BPD (0.99; 0.52, 1.89, p=0.974) did not. Mediation analyses confirmed these results.Conclusions Although traditionally BPD has been associated with low lung function in later life, these data show that gestation and IUGR are significantly associated with PLD in childhood but BPD is not. By identifying children with PLD, we can better understand the underlying mechanisms and develop optimal therapies.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Kylie Hart has nothing to disclose.Conflict of interest: Dr. Cousins has nothing to disclose.Conflict of interest: Dr. Watkins reports grants from Moulton Foundation, outside the submitted work; .Conflict of interest: Prof. Kotecha reports grants from Medical Research Council, grants from GSK, during the conduct of the study; grants from NIHR/HTA, grants and personal fees from Aspire Pharma, grants from Moulton Foundation, outside the submitted work.Conflict of interest: Dr. Watkins reports grants from Moulton Foundation, outside the submitted work; .Conflict of interest: Dr. Kotecha reports grants from Moulton Foundation, outside the submitted work; .