Respiratory Morbidity / Quality of Life
Despite lung function impairment, the prevalence of current asthma symptoms in adolescents with BPD was not different from that in other adolescents, although our study was not powered to find differences in respiratory morbidity. This finding is consistent with that in a recent review6, and in general, it differs from that described in adolescents and adults who had BPD in the pre-surfactant era. At that time, these individuals had greater respiratory morbidity than did controls without BPD2. The clinical improvement in adolescents with “new” BPD could be explained by “catch-up” alveolar growth and airway repair after neonatal injury because they experienced less structural damage than did those with “classic” BPD7.
Moreover, the prevalence of current asthma in each group in our study is comparable with that recorded in Spanish adolescents in the ISAAC Phase III study (10.6%) and is somewhat lower than that in the world population (14.1%)38. We would like to emphasize that according to ISAAC methodology, the current asthma prevalence refers to the occurrence of wheezing episodes in the previous year. Therefore, the diagnostic approach of asthma-like symptoms in BPD adolescents is not the same as that of typical asthma, although there may be overlap between the 2 conditions.
The scores of the quality of life questionnaire were similar across all groups, and they were within normal ranges when compared to the reference scores10. It has been documented that the quality of life is similar in adolescents who were born very preterm and those who were born full-term39. In addition, a negative impact of BPD on quality of life in the early years has been demonstrated; however, the scores of EP infants with BPD do not seem to differ from those of healthy controls as they reach school age and adolescence40.