title: Pulmonary outcome and its correlates in school-aged children born with a gestational age ≤ 32 weeks.
abstract: BACKGROUND
  There is limited data regarding factors influencing the respiratory outcome at school age of ex-preterms born since the introduction of antenatal steroids, surfactant replacement together with less aggressive ventilation.
  
  
  OBJECTIVE
  To establish the main antenatal, neonatal and early childhood respiratory correlates of respiratory status in school-aged children born at ≤ 32 weeks of gestation.
  
  
  METHODS
  Ex-preterm children born at ≤ 32 weeks of gestation between 1997 and 2001 at Bordeaux University Hospital were evaluated at school age, using a respiratory questionnaire and lung function tests (spirometry, plethysmography, exercise challenge test and CO lung diffusing capacity DLCO measurements). Factors associated with lung function were investigated using polynomial regression analyses.
  
  
  RESULTS
  Of the 151 included children [mean age: 8.6 ± 0.8 years; mean gestational age, 30.1 ± 1.7 weeks; mean birth weight = 1310 ± 380 g; 68.2% ventilated at birth; 46.4% treated with surfactant; 36.4% with prior bronchopulmonary dysplasia (BPD)], 47% presented obstructive lung abnormalities, 11% restrictive or mixed lung abnormalities, 41% exercise-induced bronchoconstriction, and 15.5% reduced DLCO. Surfactant therapy was independently associated with a lower risk of lung abnormalities (p < 0.05). The association between BPD and lung abnormalities at school age was not significant, but prior BPD increased the risk of restrictive or mixed abnormalities (odds ratio: 6.11, confidence interval [1.1; 33.99]). Early childhood respiratory events were not associated with the occurrence of lung abnormalities.
  
  
  CONCLUSIONS
  Children born at ≤ 32 weeks of gestation remain at risk for impaired lung function at school age in particular when they did not receive surfactant. Restrictive or mixed lung defects are mainly associated with prior BPD.
authors.affiliation: Univ. Bordeaux, Centre Cardio Thoracique, U1045, F-33000 Bordeaux, France; INSERM, Centre Cardio Thoracique, U1045, F-33000 Bordeaux, France; CHU de Bordeaux, Exploration Respiratoire, F-33000 Bordeaux, France. Electronic address: marie-luce.choukroun@u-bordeaux2.fr.
authors.forename: Marie-Luce
authors.initials: ML
authors.lastname: Choukroun
authors.forename: Hala
authors.initials: H
authors.lastname: Feghali
authors.forename: Sandrine
authors.initials: S
authors.lastname: Vautrat
authors.forename: Fabienne
authors.initials: F
authors.lastname: Marquant
authors.forename: Fabienne
authors.initials: F
authors.lastname: Nacka
authors.forename: Valériane
authors.initials: V
authors.lastname: Leroy
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Demarquez
authors.forename: Michaël J
authors.initials: MJ
authors.lastname: Fayon
mesh_terms: D001250:Asthma, Exercise-Induced / Q000503:physiopathology; D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology; D002648:Child; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008173:Lung Diseases, Obstructive / Q000503:physiopathology; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012120:Respiration Disorders / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000502:physiology; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use
chemical_list: D011663:Pulmonary Surfactants; D013256:Steroids
keywords: Bronchopulmonary dysplasia; Children; Lung function tests; Mid term outcome; Premature birth