The EPICure Study: Association between Hemodynamics and Lung Function at 11 Years after Extremely Preterm Birth - 22/09/12
, Janet Stocks, PhD 2, Enid Hennessy, PhD 3, John R. Cockcroft, FRCP 4, Joseph Fawke, MRCPCH 5, Sooky Lum, PhD 2, Carmel M. McEniery, PhD 6, Ian B. Wilkinson, FRCP, DM 6, Neil Marlow, DM, FMedSci 7
Reprint requests: Dr Charlotte E. Bolton, NIHR Nottingham Respiratory Biomedical Research Unit, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.Abstract |
Objective |
To investigate the relationship between disturbed lung function and large-artery hemodynamics in school-age children born extremely preterm (EP) (at 25 completed weeks of gestation or less).
Study design |
This was a cross-sectional study of participants from the EPICure study, now aged 11 years (n = 66), and 86 age- and sex-matched term-born classmates. Spirometry parameters (including forced expiratory volume in 1 second), blood pressure, and augmentation index (AIx, a composite of arterial stiffness and global wave reflections) were measured.
Results |
Compared with their classmates, the EP children had significantly impaired lung function, particularly those with neonatal bronchopulmonary dysplasia. Peripheral blood pressure did not differ significantly between the 2 groups, but AIx values were on average 5% higher (95% CI, 2%-8%) in the preterm infants, remaining significant after adjustment for potential confounders. Neonatal bronchopulmonary dysplasia status was not related to AIx. Lung function and maternal smoking were independently associated with AIx; AIx increased by 2.7% per z-score reduction in baseline forced expiratory volume in 1 second and by 4.9% in those whose mothers smoked during pregnancy.
Conclusion |
The independent association between impaired lung function and cardiovascular physiology in early adolescence implies higher cardiovascular risk for children born EP, and suggests that prevention of chronic neonatal lung disease may be a priority in reducing later cardiovascular risk in preterm infants.
Le texte complet de cet article est disponible en PDF.Keyword : AIx, BP, BPD, COPD, EP, FEF25-75, FEV1, FVC, MAP
Plan
| The EPICure studies were sponsored by the University of Nottingham (ending September 2008) and subsequently by University College London. A list of EPICure Studies Steering Committee members is available at www.jpeds.com (Appendix). |
|
| This research was funded by a Medical Research Council Programme grant (to N.M.). N.M. receives funding from the Department of Health’s National Institute for Health Research Biomedical Research Centre’s funding scheme at University College London Hospitals/University College London. C.B. is funded by the National Institute of Health Research Nottingham Respiratory Biomedical Research Unit. C.M. is a British Heart Foundation Intermediate Fellow, and I.W. is a British Heart Foundation Senior Fellow. The authors declare no conflicts of interest. |
Vol 161 - N° 4
P. 595 - octobre 2012 Retour au numéro
Article précédent
- 50 Years Ago in The Journal of Pediatrics : A Study of Premature Infants Fed Cold Formula
- David J. McCulley, Jamie J. Limjoco
- Pediatric Idiopathic Intracranial Hypertension and Extreme Childhood Obesity
- Sonu M. Brara, Corinna Koebnick, Amy H. Porter, Annette Langer-Gould
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?