The Effects of Neonatal Hyperoxia on Lung Development

Advances in neonatal care have enabled infants to survive extreme prematurity. Supplemental oxygen therapy is usually required and can lead to life-long alterations in the lungs as a result of oxidative stress and inflammation. The conducting airways, gas-exchanging tissue, and the pulmonary vasculature can all be affected by neonatal exposure to hyperoxia and can contribute to the increased risk of persistent pulmonary dysfunction. Ongoing inflammation may also increase the risk of respiratory infection and asthma later in life. Improvements in long-term outcomes in pulmonary health are likely to result from changes in clinical practice that target minimizing hyperoxia exposure, as well as therapies aimed at preventing and/or repairing neonatal lung injury. As supplemental oxygen is currently unavoidable in the care of very preterm infants, future studies should aim to determine the most effective methods for reducing lung injury in infancy and for identifying long-term effects on the lungs.