title: Perinatal factors associated with long-term respiratory sequelae in extremely low birthweight infants.
abstract: OBJECTIVE
  To assess lung function at 8 years old in extremely low birthweight (ELBW) survivors and to identify perinatal determinants associated with impaired lung function.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Level III neonatal intensive care unit.
  
  
  METHODS
  ELBW survivors born in 1990-2004 with available spirometry at 8 years old were studied. Children were excluded if they had a Wechsler Intelligence Scale for Children Third Edition full IQ <70.
  
  
  METHODS
  Multivariate logistic regression analysis was used to identify perinatal determinants associated with airway obstruction (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <80%) at school age and the predictive power of potential determinants. Potential risk factors and predictors assessed in this study were gestational age, birth weight, small for gestational age, sex, chorioamnionitis, premature rupture of membranes, antenatal steroids, surfactant administration, respiratory distress syndrome, postnatal steroids, severe bronchopulmonary dysplasia and bubbly/cystic appearances of the lungs by X-ray during the neonatal period.
  
  
  RESULTS
  Of 656 ELBW survivors, 301 (45.9%) had attended a school-age follow-up at 8 years old. A total of 201 eligible children completed the lung function test. Bubbly/cystic appearance of the lungs (OR 4.84, 95% CI 1.26 to 18.70) was associated with a low FEV1/FVC ratio. Children with bubbly/cystic appearance had characteristics of immaturity and intrauterine inflammation.
  
  
  CONCLUSIONS
  Within a cohort of ELBW infants, a bubbly/cystic appearance of the lungs in the neonatal period was the strongest determinant of a low FEV1/FVC ratio at school age.
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishihara
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Hirano
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Katsura
authors.initials: K
authors.lastname: Matsunami
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Sumi
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Wada
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawamoto
authors.affiliation: Department of Radiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishikawa
authors.affiliation: Clinical Laboratory Medicine and Anatomic Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakayama
authors.affiliation: Department of Comparative and Developmental Psychology, Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitajima
authors.affiliation: Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Fujimura
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D005260:Female; D005315:Fetal Diseases / Q000503:physiopathology; D005541:Forced Expiratory Volume; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development / Q000502:physiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007564:Japan; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data
keywords: Neonatology; Respiratory