University of Oulu

Näsänen-Gilmore P, Sipola-Leppänen M, Tikanmäki M, Matinolli H-M, Eriksson JG, Järvelin M-R, et al. (2018) Lung function in adults born preterm. PLoS ONE 13(10): e0205979.

Lung function in adults born preterm

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Author: Näsänen-Gilmore, Pieta1; Sipola-Leppänen, Marika1,2,3; Tikanmäki, Marjaana1,2;
Organizations: 1National Institute for Health and Welfare, Helsinki and Oulu, Finland
2Institute of Health Sciences, University of Oulu, Oulu, Finland
3PEDEGO Research Unit, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Folkhälsan Research Centre, Helsinki, Finland
5Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
6Vaasa Central Hospital, Vaasa, Finland
7MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
8Biocenter Oulu, University of Oulu, Oulu, Finland
9Unit of Primary Care, Oulu University Hospital, Oulu, Finland
10Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
11Department of Clinical and Molecular Medicine, Norwegian University of Health and Technology, Trondheim, Norway
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
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Language: English
Published: Public Library of Science, 2018
Publish Date: 2018-12-10


Very preterm birth, before the gestational age (GA) of 32 weeks, increases the risk of obstructed airflow in adulthood. We examined whether all preterm births (GA<37 weeks) are associated with poorer adult lung function and whether any associations are explained by maternal, early life/neonatal, or current life factors. Participants of the ESTER Preterm Birth Study, born between 1985 and 1989 (during the pre-surfactant era), at the age of 23 years participated in a clinical study in which they performed spirometry and provided detailed medical history. Of the participants, 139 were born early preterm (GA<34 weeks), 239 late preterm (GA: 34-<37 weeks), and 341 full-term (GA≥37 weeks). Preterm birth was associated with poorer lung function. Mean differences between individuals born early preterm versus full-term were -0.23 standard deviation (SD) (95% confidence interval (CI): -0.40, -0.05)) for forced vital capacity z-score (zFVC), -0.44 SD (95% CI -0.64, -0.25) for forced expiratory volume z-score (zFEV1), and -0.29 SD (95% CI -0.47, -0.10) for zFEV1/FVC. For late preterm, mean differences with full-term controls were -0.02 SD (95% CI -0.17, 0.13), -0.12 SD (95% CI -0.29, 0.04) and -0.13 SD (95% CI -0.29, 0.02) for zFVC, zFEV1, and zFEV1/FVC, respectively. Examination of finer GA subgroups suggested an inverse non-linear association between lung function and GA, with the greatest impact on zFEV1 for those born extremely preterm. The subgroup means were GA<28 weeks: -0.98 SD; 28-<32 weeks: -0.29 SD; 32-<weeks: -0.44 SD; 34-<36 weeks: -0.10 SD; 36-<37weeks: -0.11 SD; term-born controls (≥37weeks): 0.02 SD. Corresponding means for zFEV1/FVC were -1.79, -0.44, -0.47, -0.48, -0.29, and -0.02. Adjustment for maternal pregnancy conditions and socioeconomic and lifestyle factors had no major impact on the relationship. Preterm birth is associated with airflow limitation in adult life. The association appears to be attributable predominantly to those born most immature, with only a modest decrease among those born preterm at later gestational ages.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 13
Issue: 10
Article number: e0205979
DOI: 10.1371/journal.pone.0205979
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Copyright information: © 2018 Näsänen-Gilmore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.