Obstructive lung disease in children with mild to severe BPD.
BACKGROUND
Bronchopulmonary dysplasia (BPD) is a common cause of respiratory insufficiency in children born very premature.


OBJECTIVE
The purpose of this study was to examine the impact of the severity of BPD on pulmonary morbidity at school age, as measured by conventional spirometry and impulse oscillometry. We also studied the association between changes in lung function and structural changes in the lungs of children with BPD via High-Resolution Computed Tomography (HRCT). Finally we studied the prevalence of atopy associated with BPD.


METHODS
We studied 60 very low birth weight (VLBW) children, 28 with respiratory distress syndrome (RDS) who did not develop BPD ("preterm non-BPD") and 32 with RDS who developed BPD. The severity of BPD was graded as mild, moderate or severe. Follow-up at age 6-8 years consisted of spirometry, oscillometry, thoracic HRCT, allergy skin-prick test, blood samples and a questionnaire.


RESULTS
All children with BPD showed some evidence of impaired lung function (more negative reactance, FEV1<80% predicted, greater reversibility), although less than half of these children were symptomatic. The majority of children with BPD (19/26) showed abnormalities on HRCT. There was no evidence that atopy was associated with BPD.


CONCLUSIONS
Children with mild BPD exhibited similar impairments in respiratory mechanics and lung structure to those diagnosed with moderate BPD. The widespread involvement of the peripheral airways suggests that all children diagnosed with BPD are potentially at risk of developing chronic obstructive pulmonary disease later in life.
Broström
Eva Berggren
EB
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Pediatrics, Stockholm, Sweden. eva.berggren-brostrom@karolinska.se
Thunqvist
Per
P
Adenfelt
Gunilla
G
Borling
Elisabeth
E
Katz-Salamon
Miriam
M
D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D019102:Infant, Very Low Birth Weight; D008173:Lung Diseases, Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies