2018 year in review: Part 2 of 4: Neonatal lung disease复制标题

2018回顾年: 部分: 新生儿肺病

Thunqvist and colleagues reported that pulmonary function testing using spirometry and oscillometry 6.5 years after pre-term birth at 22- 26 weeks EGA showed increased bronchore activity to β-agonist treatment along with impaired FVC and FEV1.The authors reported that nearly all their subjects were diagnosed with BPD, which likely affected the magnitude of impaired pulmonary function. As expected, the severity of BPD correlated with the severity of impairment. Lo and colleagues reported parallel decrements of FRC in survivors of preterm birth at 26 weeks that were measured by plethysmography and Hedilution at age 1 year and age 11-14 years. The superimposition of rapid weight gain may also contribute in this setting. Lowe and colleagues correlated high rates of fetal and infant growth among the prematurely born with postnatally reported wheezing. The effect was further worsened by maternal smoking.Jackson and colleagues analyzed data from the multi-center ELGAN study to identify risk factors for BPD and correlations with parent reported asthma in those study subjects. They found that growth restriction and gestational age affected BPD risk, but that BPD only predicted bronchodilator use at 1 and 2 years, not asthma at 10 years. As others have shown, the wheezing in patients with BPD is not allergic asthma: wheezing may be driven by abnormal airway structural development. We know that effects of BPD and prematurity on airway resistance and FRC are long-standing, but this does not appear to be the same as increasing the risk for allergic asthma. Along with other reports, the authors found that weight gain velocity during infancy also increased the risk for asthma along with maternal SES, another example of disturbed developmental programming.

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