title: Adult respiratory outcomes of extreme preterm birth. A regional cohort study.
abstract: BACKGROUND
  Lifetime respiratory function after extremely preterm birth (gestational age≤28 wk or birth weight≤1,000 g) is unknown.
  
  
  OBJECTIVE
  To compare changes from 18-25 years of age in respiratory health, lung function, and airway responsiveness in young adults born extremely prematurely to that of term-born control subjects.
  
  
  METHODS
  Comprehensive lung function investigations and interviews were conducted in a population-based sample of 25-year-old subjects born extremely prematurely in western Norway in 1982-1985, and in matched term-born control subjects. Comparison was made to similar data collected at 18 years of age.
  
  
  RESULTS
  At 25 years of age, 46/51 (90%) eligible subjects born extremely prematurely and 39/46 (85%) control subjects participated. z-Scores for FEV1, forced expiratory flow at 25-75% of vital capacity, and FEV1/FVC were significantly reduced in subjects born extremely prematurely by 1.02, 1.26, and 0.88, respectively, and airway resistance (kPa/L/s) was increased (0.23 versus 0.18). Residual volume to total lung capacity increased with severity of neonatal bronchopulmonary dysplasia. Responsiveness to methacholine (dose-response slope; 3.16 versus 0.85) and bronchial lability index (7.5 versus 4.8%) were increased in subjects born extremely prematurely. Lung function changes from 18 to 25 years and respiratory symptoms were similar in the prematurely born and term-born groups.
  
  
  CONCLUSIONS
  Lung function in early adult life was in the normal range in the majority of subjects born extremely prematurely, but methacholine responsiveness was more pronounced than in term-born young adults, suggesting a need for ongoing pulmonary monitoring in this population.
authors.affiliation: 1 Department of Clinical Science, Section for Pediatrics, University of Bergen, Bergen, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Vollsæter
authors.forename: Hege H
authors.initials: HH
authors.lastname: Clemm
authors.forename: Emma
authors.initials: E
authors.lastname: Satrell
authors.forename: Geir E
authors.initials: GE
authors.lastname: Eide
authors.forename: Ola D
authors.initials: OD
authors.lastname: Røksund
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
authors.forename: Thomas
authors.initials: T
authors.lastname: Halvorsen
mesh_terms: D000293:Adolescent; D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D005544:Forecasting; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000503:physiopathology*; D008168:Lung; D008297:Male; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013147:Spirometry; D014109:Total Lung Capacity; D055815:Young Adult
keywords: bronchopulmonary dysplasia; chronic obstructive pulmonary disease; premature birth