Pulmonary function in children with initial low birth weight.
The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks; 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.
Wjst
M
M
GSF-Forschungszentrum fuer Umwelt und Gesundheit, Institut fuer Epidemiologie, Neuherberg, Germany.
Popescu
M
M
Trepka
M J
MJ
Heinrich
J
J
Wichmann
H E
HE
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003139:Common Cold / Q000150:complications; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D016017:Odds Ratio; D012115:Residual Volume; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D012737:Sex Factors; D014109:Total Lung Capacity