Abstract
BackgroundBronchopulmonary dysplasia (BPD) is a risk factor for respiratory disease in adulthood. Despite the differences in underlying pathology, patients with a history of BPD are often treated as asthmatics. We hypothesized that pulmonary outcomes and health-related quality of life (HRQoL) were different in adults born preterm with and without a history of BPD compared to asthmatics and healthy individuals.MethodsWe evaluated 96 young adults from the LUNAPRE cohort (clinicaltrials.gov/ct2/show/NCT02923648), including 26 individuals born preterm with a history of BPD (BPD), 23 born preterm without BPD (preterm), 23 asthmatics and 24 healthy controls. Extensive lung function testing and HRQoL were assessed.ResultsThe BPD group had more severe airway obstruction compared to the preterm-, (FEV1− 0.94 vs. 0.28 z-scores; p ≤ 0.001); asthmatic- (0.14 z-scores, p ≤ 0.01) and healthy groups (0.78 z-scores, p ≤ 0.001). Further, they had increased ventilation inhomogeneity compared to the preterm- (LCI 6.97 vs. 6.73, p ≤ 0.05), asthmatic- (6.75, p = 0.05) and healthy groups (6.50 p ≤ 0.001). Both preterm groups had lower DLCO compared to healthy controls (p ≤ 0.001 for both). HRQoL showed less physical but more psychological symptoms in the BPD group compared to asthmatics.ConclusionsLung function impairment and HRQoL in adults with a history of BPD differed from that in asthmatics highlighting the need for objective assessment of lung health.
Highlights
Bronchopulmonary dysplasia (BPD) is a risk factor for respiratory disease in adulthood
Participants We included four adult study groups: preterm born at gestational age (GA) ≤ 32 weeks with a neonatal diagnosis of BPD (BPD), preterm without BPD, patients with asthma according to Global Initiative for Asthma (GINA) guidelines [14] and healthy controls as part of the LUNAPRE (LUNg obstruction in Adulthood of PREmaturely born) study
Three subjects in the BPD group and five in the preterm group were excluded due to tobacco smoking resulting in a final inclusion of 26 and 23 individuals respectively
Summary
Bronchopulmonary dysplasia (BPD) is a risk factor for respiratory disease in adulthood. We hypothesized that pulmonary outcomes and health-related quality of life (HRQoL) were different in adults born preterm with and without a history of BPD compared to asthmatics and healthy individuals. We hypothesized that adults born preterm, in particular those with a history of BPD, have a respiratory impairment that is different from what is observed in asthma, and that this significantly affects quality of life. To test this hypothesis, we examined in a cross-sectional setting never-smoking adults born preterm with and without a previous diagnosis of neonatal BPD and compared them to patients with asthma and healthy individuals. We aimed to characterize functional abnormalities in the airways and lung parenchyma and to correlate the findings to symptoms, quality of life and demographics
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