[Lung Function in Childhood and Adolescence: Influence of Prematurity and Bronchopulmonary Dysplasia].
BACKGROUND
The introduction of prenatal steroids, surfactant replacement therapy and gentle ventilation modes has reduced short term respiratory morbidity and increased survival of very preterm infants. However, there is some evidence that prenatal factors, the extend of prematurity and bronchopulmonary dysplasia (BPD) may affect pulmonary function in childhood and adolescence.


METHODS
We have performed a comprehensive review on the outcome of pulmonary function after premature birth before 32 weeks of gestation in the era of surfactant replacement therapy and tried to evaluate the influence of chorioamnionitis, intrauterine growth retardation (IUGR), maternal metabolic syndrome, prematurity and BPD on long term pulmonary function.


RESULTS
Some children and adolescents born very preterm may experience significant airflow reduction. The bronchial obstruction in these patients is not entirely reversible by inhalative ß2-mimetics. The degree of pulmonary function impairment is partly correlated with the degree of BPD. Abnormalities in pulmonary diffusion capacity may occur after extreme prematurity, but also in patients with moderate and severe BPD. IUGR may have a negative impact on later pulmonary function in very children. There is insufficient data to assess the preterm impact of chorioamnionitis or maternal metabolic syndrome on later lung function.


CONCLUSIONS
Infants born before 32 weeks of gestational age in the surfactant era still carry an increased risk to suffer an impaired pulmonary function in childhood and adolescence, particularly if they survived with BPD. Long term pulmonary care for these patients should take place in specialized centers.
Universitäts-Kinderklinik, Universitätsklinikum Würzburg, Würzburg.
F J H
FJ
Segerer
Universitäts-Kinderklinik, Universitätsklinikum Würzburg, Würzburg.
C P
CP
Speer
D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data*; D017677:Age Distribution; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012120:Respiration Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution