title: Altered lung structure and function in mid-childhood survivors of very preterm birth.
abstract: Survivors of preterm birth are at risk of chronic and lifelong pulmonary disease. Follow-up data describing lung structure and function are scarce in children born preterm during the surfactant era.
  
  
  
  To obtain comprehensive data on lung structure and function in mid-childhood from survivors of preterm birth. We aimed to explore relationships between lung structure, lung function and respiratory morbidity as well as early life contributors to poorer childhood respiratory outcomes.
  
  
  
  Lung function was tested at 9-11 years in children born at term (controls) and at ≤32 weeks gestation. Tests included spirometry, oscillatory mechanics, multiple breath nitrogen washout and diffusing capacity of the lung for carbon monoxide. Preterm children had CT of the chest and completed a respiratory symptoms questionnaire.
  
  
  
  58 controls and 163 preterm children (99 with bronchopulmonary dysplasia) participated. Preterm children exhibited pulmonary obstruction and hyperinflation as well as abnormal peripheral lung mechanics compared with term controls. FEV1was improved by 0.10 z-scores for every additional week of gestation (95% CI 0.028 to 0.182; p=0.008) and by 0.34 z-scores per z-score increase in birth weight (0.124 to 0.548; p=0.002). Structural lung changes were present in 92% of preterm children, with total CT score decreased by 0.64 (-0.99 to -0.29; p<0.001) for each additional week of gestation. Obstruction was associated with increased subpleural opacities, bronchial wall thickening and hypoattenuated lung areas on inspiratory chest CT scans (p<0.05).
  
  
  
  Abnormal lung structure in mid-childhood resulting from preterm birth in the contemporary era has important functional consequences.
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.|Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.
authors.forename: Shannon J
authors.initials: SJ
authors.lastname: Simpson
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.|School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
authors.forename: Karla M
authors.initials: KM
authors.lastname: Logie
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.|Department of Respiratory and Sleep Medicine, Princess Margaret Hospital for Children, Perth, WA, Australia.|School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: O'Dea
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.
authors.forename: Georgia L
authors.initials: GL
authors.lastname: Banton
authors.affiliation: Diagnostic Imaging, Princess Margaret Hospital for Children, Perth, WA, Australia.
authors.forename: Conor
authors.initials: C
authors.lastname: Murray
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.|Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.|School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.|Department of Respiratory and Sleep Medicine, Princess Margaret Hospital for Children, Perth, WA, Australia.|School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Wilson
authors.affiliation: Department of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, WA, Australia.
authors.forename: J Jane
authors.initials: JJ
authors.lastname: Pillow
authors.affiliation: Telethon Kids Institute, Perth, WA, Australia.|Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.|School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
authors.forename: Graham L
authors.initials: GL
authors.lastname: Hall
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013147:Spirometry; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity / Q000502:physiology*
keywords: Imaging/CT MRI etc; Lung Physiology; Paediatric Lung Disaese; Respiratory Measurement