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Lung abnormalities do not influence aerobic capacity in school children born preterm

European Journal of Applied Physiology volume 121, pages 489–498 (2021)Cite this article

Abstract

Purpose

Children born preterm have impaired lung function and altered lung structure. However, there are conflicting reports on how preterm birth impacts aerobic exercise capacity in childhood. We aimed to investigate how neonatal history and a diagnosis of bronchopulmonary dysplasia (BPD) impact the relationship between function and structure of the lung, and aerobic capacity in school-aged children born very preterm.

Methods

Preterm children (≤ 32 w completed gestation) aged 9–12 years with (n = 38) and without (n = 35) BPD, and term-born controls (n = 31), underwent spirometry, lung volume measurements, gas transfer capacity, a high-resolution computer tomography (CT) scan of the chest, and an incremental treadmill exercise test.

Results

Children born preterm with BPD had an elevated breathing frequency to tidal volume ratio compared to term controls (76% vs 63%, p = 0.002). The majority (88%) of preterm children had structural changes on CT scan. There were no differences in peak V̇O2 (47.1 vs 47.7 mL/kg/min, p = 0.407) or oxygen uptake efficiency slope when corrected for body weight (67.6 vs 67.3, p = 0.5) between preterm children with BPD and term controls. There were no differences in any other exercise outcomes. The severity of structural lung disease was not associated with exercise outcomes in this preterm population.

Conclusion

Children born preterm have impaired lung function, and a high prevalence of structural lung abnormalities. However, abnormal lung function and structure do not appear to impact on the aerobic exercise capacity of preterm children at school age.

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Fig. 1

Abbreviations

ANOVA:

Analysis of variance

AT:

Anaerobic threshold

BPD:

Bronchopulmonary dysplasia

CPAP:

Continuous positive airways pressure

CT:

Computed tomography

FEV1:

Forced expiratory volume in 1 s

FOT:

Forced oscillation technique

ƒR :

Respiratory frequency

FRC:

Functional residual capacity

GA:

Gestational age

HR:

Heart rate

MV:

Mechanical ventilation

MVV:

Maximum voluntary ventilation

PMA:

Post menstrual age

RER:

Respiratory exchange ratio, respiratory quotient

RV:

Residual volume

TLC:

Total lung capacity

TLCO:

Transfer factor of the lung for carbon monoxide

VA:

Alveolar volume

\(\dot{V}\)̇CO2 :

Carbon dioxide production

\(\dot{V}\)̇E:

Minute ventilation

\(\dot{V}\)̇O2 :

Oxygen uptake

V T :

Tidal volume

References

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Acknowledgements

This work was funded by the Princess Margaret Hospital Foundation; Raine Medical Research Foundation; National Health and Medical Research Council (APP513730, APP1025550, APP1073301, APP1077691).

Author information

Affiliations

  1. Respiratory Medicine, Perth Children’s Hospital, Perth, WA, Australia

    Christopher A. O’Dea, Andrew C. Wilson & Graham L. Hall

  2. School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia

    Christopher A. O’Dea, Andrew C. Wilson, Shannon J. Simpson, Graham L. Hall & Andrew Maiorana

  3. Telethon Kids Institute, Perth, WA, Australia

    Christopher A. O’Dea, Karla Logie, Andrew C. Wilson, Georgia Banton, Shannon J. Simpson & Graham L. Hall

  4. Centre for Child Health Research, University of Western Australia, Perth, WA, Australia

    Karla Logie, Andrew C. Wilson, Shannon J. Simpson & Graham L. Hall

  5. Division of Paediatrics and Child Health, Medical School, University of Western Australia, Perth, WA, Australia

    Karla Logie & J. Jane Pillow

  6. Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, WA, Australia

    Andrew Maiorana

  7. School of Human Sciences, University of Western Australia, Perth, WA, Australia

    J. Jane Pillow

  8. Diagnostic Imaging, Perth Children’s Hospital, Perth, WA, Australia

    Conor Murray

Authors
  1. Christopher A. O’Dea
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  2. Karla Logie
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  3. Andrew C. Wilson
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  4. J. Jane Pillow
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  5. Conor Murray
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  6. Georgia Banton
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  7. Shannon J. Simpson
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  8. Graham L. Hall
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  9. Andrew Maiorana
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Contributions

COD performed data measurement and interpretation, conducted the statistical analysis and drafted the initial versions of the manuscript. KL and GB performed data measurement and revision of the manuscript. SS performed data measurement, assisted with data analysis and interpretation and revision of manuscript. AM, AW, JP and GH designed the study, obtained funding, had oversight of data collection and interpretation and reviewed the manuscript.

Corresponding author

Correspondence to Andrew Maiorana.

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Communicated by Ellen Adele Dawson.

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O’Dea, C.A., Logie, K., Wilson, A.C. et al. Lung abnormalities do not influence aerobic capacity in school children born preterm. Eur J Appl Physiol 121, 489–498 (2021). https://doi.org/10.1007/s00421-020-04530-2

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  • DOI: https://doi.org/10.1007/s00421-020-04530-2

Keywords

  • Exercise and lung disease
  • Bronchopulmonary dysplasia
  • Imaging/CT
  • Paediatric lung disease
  • Lung physiology