ISSUES RELATING TO CHILDREN BORN PREMATURELY

Preterm infants suffer increased risk of acute and chronic respiratory disorders. In patients with chronic lung disease or severe bronchopul monary dysplasia, long-term respiratory morbidity and pulmonary dysfun ction into late childhood and early adulthood have been reported. This includes symptomatic morbidity (recurrent cough and/or wheeze) and lu ng function abnormalities such as increased resistance to airflow, air way hyperresponsiveness, and increased propensity to air-trapping. To date, no clinically significant association between prematurity and cl assical atopic asthma has been demonstrated, Therefore, interventions should primarily focus on the reduction of wheezing disorders and lung function abnormalities in children horn prematurely. In order to desi gn interventions in the foetal and early neonatal period or during chi ldhood the potential risk factors for long-term morbidity need to be c arefully identified at different age groups: factors which affect pre- and postnatal lung growth, airway inflammation, viral infections, air pollution and others. Future research issues should include well-cond ucted prospective follow-up programmes which will identify major risk factors in specific populations. Early intervention will provide infor mation on disease mechanisms and on new prophylactic as well as therap eutic strategies.