Can infant lung function predict respiratory morbidity during the first year of life in preterm infants?
Compared with term-born infants, preterm infants have increased respiratory morbidity in the first year of life. We investigated whether lung function tests performed near term predict subsequent respiratory morbidity during the first year of life and compared this to standard clinical parameters in preterms. The prospective birth cohort included randomly selected preterm infants with and without bronchopulmonary dysplasia. Lung function (tidal breathing and multiple-breath washout) was measured at 44 weeks post-menstrual age during natural sleep. We assessed respiratory morbidity (wheeze, hospitalisation, inhalation and home oxygen therapy) after 1 year using a standardised questionnaire. We first assessed the association between lung function and subsequent respiratory morbidity. Secondly, we compared the predictive power of standard clinical predictors with and without lung function data. In 166 preterm infants, tidal volume, time to peak tidal expiratory flow/expiratory time ratio and respiratory rate were significantly associated with subsequent wheeze. In comparison with standard clinical predictors, lung function did not improve the prediction of later respiratory morbidity in an individual child. Although associated with later wheeze, noninvasive infant lung function shows large physiological variability and does not add to clinically relevant risk prediction for subsequent respiratory morbidity in an individual preterm.
Paediatric Pulmonology, Inselspital and University of Bern, Bern, Switzerland University Children's Hospital (UKBB), Basel, Switzerland These authors contributed equally to this work.
Elena
E
Proietti
Paediatric Intensive Care, Inselspital and University of Bern, Switzerland These authors contributed equally to this work.
Thomas
T
Riedel
Paediatric Pulmonology, Inselspital and University of Bern, Bern, Switzerland University Children's Hospital, Munich, Germany.
Oliver
O
Fuchs
University Children's Hospital (UKBB), Basel, Switzerland.
Isabelle
I
Pramana
Paediatric Pulmonology, Inselspital and University of Bern, Bern, Switzerland University Children's Hospital, Zurich, Switzerland.
Florian
F
Singer
Paediatric Pulmonology, Inselspital and University of Bern, Bern, Switzerland University Children's Hospital (UKBB), Basel, Switzerland.
Anne
A
Schmidt
Institute for Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Claudia
C
Kuehni
Paediatric Pulmonology, Inselspital and University of Bern, Bern, Switzerland University Children's Hospital (UKBB), Basel, Switzerland.
Philipp
P
Latzin
University Children's Hospital (UKBB), Basel, Switzerland.
Urs
U
Frey
D019540:Area Under Curve; D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010102:Oxygen Inhalation Therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012119:Respiration; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013990:Tidal Volume