LONG-TERM PULMONARY FUNCTIONAL OUTCOME OF BRONCHOPULMONARY DYSPLASIA AND PREMATURE BIRTH

Pulmonary function and exercise tolerance were evaluated in late child hood in two groups of prematurely born children: one group with bronch opulmonary dysplasia (BPD) [n = 15; gestational age at birth (GA): 29. 6 +/- 2.8 weeks; birth weight (BW): 1,367 +/- 548 g; age at test: 7.9 +/- 0.6 years], and a second group without significant neonatal lung d isease [pre-term (PT)] (n = 9; GA: 30.3 +/- 1.7 weeks; BW: 1,440 +/- 3 76 g; age at test: 7.8 +/- 0.22 years). The results were compared with a control group of children of similar ages and heights, born at term [term born (TB)]. We observed that total lung resistance (R(L)) was s ignificantly higher in BPD (11 +/- 3 cmH(2)O/L/s), and in PT (9 +/- 2) than in TB [5 +/- 1, (P < 0.001 and P < 0.05, respectively)]. In BPD R, was higher than in PT (P < 0.05). Dynamic lung compliance (C-Ldyn) was decreased in BPD (43 +/- 11 mL/cmH(2)O) and in PT (56 +/- 17) comp ared with TB (76 +/- 20) (P < 0.001 and P < 0.05), and also in BPD com pared with PT (P < 0.05). Forced expiratory volume in 1 second (FEV,) and FEV(1)/forced vital capacity (FVC) were lower in BPD (1.07 +/- 0.1 5 L and 72 +/- 7%) than in PT (1.29 +/- 0.23 L, and 80 +/- 7%) (P < 0. 05). Exercise tests were performed in six boys with BPD. The ratio bet ween minute ventilation at maximal workload (V-max) and the predicted value of maximal voluntary ventilation (MVV) was elevated in the six B PD boys tested, compared with five boys of Group 2 and five TB boys (8 7 +/- 15% vs. 62 +/- 14% and 65 +/- 13%) (P < 0.05). We conclude that: 1) prematurity and BPD is followed by long-term airway obstruction an d a mild degree of exercise intolerance and; 2) premature birth withou t BPD may be followed by a milder degree of airway obstruction in chil dhood than in infants who developed BPD during the neonatal period. (C ) 1995 Wiley-Liss, Inc.