Spirometry/Pulmonary Volumes
Previous studies showed that adolescents who developed BPD in the pre-surfactant era had greater airflow limitation and air-trapping than EP adolescents without BPD and full-term control individuals; these differences tended to persist over time2,3.
With regard to adolescents born in the post-surfactant era, there is less information available, and only a few have reached adulthood20. Available data show that differences between children with BPD aged 6 to 12 years and full-term controls are similar to those observed previously2. However, studies comparing pulmonary function between EP children aged 6 to 12 years with and without BPD have shown somewhat contradictory findings. Some studies reported that those with BPD had greater airway obstruction and air-trapping21-25, while other studies found no differences in either spirometry or pulmonary volumes between EP children with and without BPD18,23,24. This study focused on 14-year-old adolescents who developed BPD in the post-surfactant era. We found that they had greater airflow limitation and air-trapping than EP adolescents without BPD and MLP adolescents2,3. The differences between the EP adolescents with and without BPD suggest that BPD is associated with deficits in pulmonary function in addition to the complications related to prematurity itself. Notably, most adolescents with BPD in our study had mild pulmonary function deficits, and even patients in the “high severity” BPD subgroup reached acceptable results. Despite this, further follow-up is necessary to assess the long-term consequences of early lung injury, particularly in patients with spirometry values below the LLN who usually experience more severe forms of BPD. Indeed, it is possible that BPD is linked to the development of chronic obstructive pulmonary disease in adulthood4.
Interestingly, we found that spirometry values were within the normal range in most adolescents in the EP-noBPD group, and the findings suggest that the lung may be able to resume its growth and alveolarization process after disruption caused by premature birth, although the recovery might not be completely achieved26. These results differ from those reported by Fawke et al. 21, who showed a slightly higher deficit in lung function in EP-noBPD adolescents. This discrepancy may be due to the differences in participants’ age and clinical characteristics. The patients in Fawke et al.’s21study were 11 years old with a mean GA of 25 weeks, and the patients in our study were 14 years old with a mean GA of 27 weeks.