Lung Function in Very Low Birth Weight Adults.
OBJECTIVE
Lung function attained in young adulthood is 1 of the strongest predictors of obstructive airways disease in later life. Adults born preterm at very low birth weight (VLBW; <1500 g) who have experienced bronchopulmonary dysplasia (BPD) have reduced lung function. We studied the association of lung function in young adulthood with preterm birth at VLBW and with BPD and other prenatal and neonatal conditions.


METHODS
We performed spirometry for 160 VLBW subjects (29 with BPD according to Northway criteria) aged 18 to 27 years and 162 term control subjects group-matched for gender, age, and birth hospital. Lung function was expressed as z scores according to the Global Lung Function Initiative standards.


RESULTS
Forced expiratory volume in 1 second z score was 1.41 units (95% confidence interval [CI]: 0.89 to 1.94) lower in BPD-VLBW subjects and 0.39 units (95% CI: 0.08 to 0.69) in non-BPD VLBW subjects compared with control subjects. Corresponding differences for forced expiratory volume in 1 second/forced vital capacity were 1.52 (95% CI: 0.99 to 2.05) and 0.51 (95% CI: 0.21 to 0.81), respectively. Maternal smoking in pregnancy predicted poorer airflow in all groups; this finding was strongest in the BPD-VLBW group. Lung function was unrelated to fetal or postnatal growth or to neonatal respiratory distress syndrome.


CONCLUSIONS
Young adults born at VLBW have reduced airflow. The outcome is stronger in those who have a history of BPD but is present among those with no such history. This finding suggests an increased risk of later obstructive airways disease in adults born at VLBW.
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland;
Heli-Kaisa
HK
Saarenpää
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Institute of Health Sciences and.
Marjaana
M
Tikanmäki
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Institute of Health Sciences and Department of Pediatrics and Adolescence, MRC Oulu, and.
Marika
M
Sipola-Leppänen
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland;
Petteri
P
Hovi
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland;
Karoliina
K
Wehkalampi
Hyvinkää Hospital, Hyvinkää, Finland;
Mirjami
M
Siltanen
Department of Obstetrics and Gynecology, MRC Oulu Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu, Finland;
Marja
M
Vääräsmäki
Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland;
Anna-Liisa
AL
Järvenpää
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Folkhälsan Research Centre, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland; and Vasa Central Hospital, Vasa, Finland.
Johan G
JG
Eriksson
Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland;
Sture
S
Andersson
National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki and Oulu, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, MRC Oulu Oulu University Hospital and University of Oulu, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu, Finland; eero.kajantie@helsinki.fi.
Eero
E
Kajantie
D000293:Adolescent; D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D012129:Respiratory Function Tests; D055815:Young Adult