Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era

Lex W. Doyle, Anne Marie Adams, Colin Robertson, Sarath Ranganathan, Noni M. Davis, Katherine J. Lee, Jeanie L. Cheong, Victorian Infant Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. Objective To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. Methods Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80% and 58%, respectively. Data were analysed using linear mixed models. Results The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95% CI -1.21 to -0.82; 18 years -0.92, 95% CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not. Conclusions Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.

Original languageEnglish
Pages (from-to)712-719
Number of pages8
JournalThorax
Volume72
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017
Externally publishedYes

Cite this

Doyle, L. W., Adams, A. M., Robertson, C., Ranganathan, S., Davis, N. M., Lee, K. J., ... Victorian Infant Study Group (2017). Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era. Thorax, 72(8), 712-719. https://doi.org/10.1136/thoraxjnl-2016-208524
Doyle, Lex W. ; Adams, Anne Marie ; Robertson, Colin ; Ranganathan, Sarath ; Davis, Noni M. ; Lee, Katherine J. ; Cheong, Jeanie L. ; Victorian Infant Study Group. / Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era. In: Thorax. 2017 ; Vol. 72, No. 8. pp. 712-719.
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abstract = "Background The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. Objective To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. Methods Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81{\%} and 70{\%} had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80{\%} and 58{\%}, respectively. Data were analysed using linear mixed models. Results The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95{\%} CI -1.21 to -0.82; 18 years -0.92, 95{\%} CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not. Conclusions Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.",
author = "Doyle, {Lex W.} and Adams, {Anne Marie} and Colin Robertson and Sarath Ranganathan and Davis, {Noni M.} and Lee, {Katherine J.} and Cheong, {Jeanie L.} and {Victorian Infant Study Group} and Anderson, {Peter J.}",
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Doyle, LW, Adams, AM, Robertson, C, Ranganathan, S, Davis, NM, Lee, KJ, Cheong, JL & Victorian Infant Study Group 2017, 'Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era' Thorax, vol. 72, no. 8, pp. 712-719. https://doi.org/10.1136/thoraxjnl-2016-208524

Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era. / Doyle, Lex W.; Adams, Anne Marie; Robertson, Colin; Ranganathan, Sarath; Davis, Noni M.; Lee, Katherine J.; Cheong, Jeanie L.; Victorian Infant Study Group.

In: Thorax, Vol. 72, No. 8, 01.08.2017, p. 712-719.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increasing airway obstruction from 8 to 18 years in extremely preterm/low-birthweight survivors born in the surfactant era

AU - Doyle, Lex W.

AU - Adams, Anne Marie

AU - Robertson, Colin

AU - Ranganathan, Sarath

AU - Davis, Noni M.

AU - Lee, Katherine J.

AU - Cheong, Jeanie L.

AU - Victorian Infant Study Group

AU - Anderson, Peter J.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. Objective To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. Methods Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80% and 58%, respectively. Data were analysed using linear mixed models. Results The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95% CI -1.21 to -0.82; 18 years -0.92, 95% CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not. Conclusions Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.

AB - Background The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. Objective To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. Methods Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80% and 58%, respectively. Data were analysed using linear mixed models. Results The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95% CI -1.21 to -0.82; 18 years -0.92, 95% CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not. Conclusions Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.

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U2 - 10.1136/thoraxjnl-2016-208524

DO - 10.1136/thoraxjnl-2016-208524

M3 - Article

VL - 72

SP - 712

EP - 719

JO - Thorax

JF - Thorax

SN - 0040-6376

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