title: Respiratory Morbidity in Infants Born With a Congenital Lung Malformation.
abstract: OBJECTIVE
  The actual frequency of respiratory symptoms related to congenital pulmonary malformations (CPMs) remains undetermined. The goal of this study was to prospectively evaluate the respiratory symptoms occurring in infants with prenatally diagnosed CPMs, identify factors associated with the occurrence of these symptoms, and evaluate their resolution after surgery.
  
  
  METHODS
  Infectious and noninfectious respiratory symptoms were prospectively collected in a French multicenter cohort of children with CPMs.
  
  
  RESULTS
  Eighty-five children were followed up to the mean age of 2.1 ± 0.4 years. Six children (7%) underwent surgery during the first 28 days of life. Of the 79 remaining children, 33 (42%) had respiratory symptoms during infancy before any surgery. Wheezing was the dominant symptom (24 of 79 [30%]), and only 1 infant had documented infection of the cystic lobe. Symptoms were more frequent in children with noncystic CPMs, prenatally (P= .01) or postnatally (P< .03), and with postnatally hyperlucent CPMs (P< .01). Sixty-six children underwent surgery during the follow-up period, and 40% of them displayed symptoms after the intervention. Six children had documented pneumonia during the postoperative period. At the end of the follow-up, pectus excavatum was observed in 10 children, significantly associated with thoracotomy (P< .02) or with surgery before the age of 6 months (P< .002).
  
  
  CONCLUSIONS
  CPMs are frequently associated with wheezing episodes. Surgery had no significant impact on these symptoms but was associated with a paradoxical increase in pulmonary infections, as well as an increased risk of pectus excavatum after thoracotomy.
authors.affiliation: Pneumologie Pédiatrique.
authors.forename: Celine
authors.initials: C
authors.lastname: Delestrain
authors.affiliation: Chirurgie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique-Hospitaux de Paris, Paris, France.|Université Paris-Descartes, Paris, France.
authors.forename: Naziha
authors.initials: N
authors.lastname: Khen-Dunlop
authors.affiliation: Pneumologie Pédiatrique.|Université Paris-Descartes, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Hadchouel
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Régional et Universitaire de Brest, Brest, France.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Cros
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier de Lens, Lens, France.
authors.forename: Héloïse
authors.initials: H
authors.lastname: Ducoin
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Fayon
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Universitaire de Tours, Tours, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gibertini
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: André
authors.initials: A
authors.lastname: Labbé
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Labouret
authors.affiliation: Pneumologie Pédiatrique, Hôpital Universitaire Robert Debré, Assistance Publique-Hospitaux de Paris, Paris, France.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Lebras
authors.affiliation: Pneumologie Pédiatrique.|Université Paris-Descartes, Paris, France.|Centre de Référence des Maladies Respiratoires Rares, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lezmi
authors.affiliation: Centre de Référence des Maladies Respiratoires Rares, Paris, France.|Pneumologie Pédiatrique, Centre Hospitalier Intercommunal Créteil,Créteil, France.
authors.forename: Fouad
authors.initials: F
authors.lastname: Madhi
authors.affiliation: Centre de Référence des Maladies Respiratoires Rares, Paris, France.|Pneumologie Pédiatrique, Hôpital Armand Trousseau, Assistance Publique Hospitaux de Paris, Paris, France; and.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Thouvenin
authors.affiliation: Pneumologie Pédiatrique, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Thumerelle
authors.affiliation: Pneumologie Pédiatrique, christophe.delacourt@nck.aphp.fr.|Université Paris-Descartes, Paris, France.|Centre de Référence des Maladies Respiratoires Rares, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Delacourt
mesh_terms: D001842:Bone and Bones / Q000002:abnormalities; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005660:Funnel Chest / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011014:Pneumonia / Q000453:epidemiology; D006831:Polyhydramnios / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth; D011656:Pulmonary Emphysema / Q000151:congenital* / Q000453:epidemiology / Q000601:surgery; D012135:Respiratory Sounds / Q000209:etiology; D015619:Respiratory System Abnormalities / Q000453:epidemiology* / Q000601:surgery; D013908:Thoracotomy / Q000009:adverse effects