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Lung function evolution in children with old and new type bronchopulmonary dysplasia: a retrospective cohort analysis

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Abstract

Bronchopulmonary dysplasia (BPD) is one of the most important sequelae of premature birth. There is concern that in some patients, lung injuries early in life may have lifelong consequences. In this retrospective observational cohort study, lung function evolution in children with BPD was investigated from childhood to young adulthood. Data from 355 pulmonary function tests (PFT) in 24 patients were analyzed, with a median age at first PFT of 7.6 years and at last PFT 18.2 years. FEV1 and FEV1/FVC were below the 5th percentile in respectively 18 and 13/24 patients. Comparing first and last measurement, there was significant worsening in FEV1 from a mean of 71.3% pred (SD 18.3) to 66.7% pred (SD 21.7) (p < 0.05) and in FEV1/FVC from 85.4% pred (SD 15.2) to 79.8% pred (SD 17.3) (p = 0.01). Evaluation of the individual lung function changes with linear regression showed deterioration in FEV1, FVC, and FEV1/FVC in respectively 17, 13, and 17/24 patients. Total group analysis showed significant deterioration in FEV1 (− 0.7%/year, p = 0.002) and FEV1/FVC (− 0.5%/year, p = 0.01). None of the 11 patients born up to 1990 improved in FEV1 vs 7 of the 13 patients born after 1990 (p = 0.006).

Conclusion: This points out to further deterioration of the lung function during childhood in this selected group of children with BPD.

What is Known:

• Data on longitudinal changes in lung function in children with BPD are scarce.

What is New:

• In children with BPD at the severe end of the disease spectrum, lung function does not improve over time. On the contrary, in two-thirds of the subjects studied FEV1and FEV1/FVC worsen over time.

• Lung function evolution towards adulthood was somewhat more favorable in children born after 1990 compared with those born earlier, probably reflecting improvements in neonatal care in subjects with new type BPD.

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Abbreviations

BD:

Bronchodilator

BPD:

Bronchopulmonary dysplasia

FEV1 :

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

LLN:

Lower limit of normal

PFT:

Pulmonary function test

pp:

Percent of predicted

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Acknowledgments

Thanks to Mrs. Els Aertgeerts for secretarial assistance.

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Authors and Affiliations

  1. Department of Pediatric Pulmonology, University Hospital Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgium

    Frederik Cardoen, François Vermeulen, Marijke Proesmans & Kris De Boeck

  2. Rehabilitation Center Pulderbos, Reebergenlaan 4, 2242, Zandhoven, Belgium

    Marleen Moens

Authors
  1. Frederik Cardoen
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  2. François Vermeulen
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  3. Marijke Proesmans
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  4. Marleen Moens
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  5. Kris De Boeck
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Contributions

FC, FV, MP, MM, and KDB designed the study. FC and FV collected the data and performed the analyses. FC wrote the draft manuscript. FC, FV, MP, MM, and KDB reviewed the manuscript and made significant additions. All authors take responsibility for the data and results.

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Correspondence to Kris De Boeck.

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The authors declare that they have no conflict of interest.

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The Ethics Committee of UZ Leuven approved the study.

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Communicated by Peter de Winter

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Cardoen, F., Vermeulen, F., Proesmans, M. et al. Lung function evolution in children with old and new type bronchopulmonary dysplasia: a retrospective cohort analysis. Eur J Pediatr 178, 1859–1866 (2019). https://doi.org/10.1007/s00431-019-03453-1

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  • DOI: https://doi.org/10.1007/s00431-019-03453-1

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