Pulmonary sequelae in long-term survivors of bronchopulmonary dysplasia.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a common problem in premature babies. Long-term sequelae are the main concerns.
METHODS: A retrospective review of all BPD children born in Queen Mary Hospital, a teaching hospital of the University of Hong Kong, from January 1987 to December 1995 was conducted. Children with cerebral palsy, immunodeficiency, congenital heart disorders, renal or liver failure were excluded from analysis. Chest radiography (CXR), electrocardiogram (ECG) and pulse oximetry were routinely performed.
RESULTS: Fifty-five children completed the study. The female to male ratio was 1:1.1. The mean gestational age was 28 weeks. Twenty-five children were born with a birthweight of less than 1001 g. Mean age at assessment was 5.4 years. Twenty-four children (44%) demonstrated signs or symptoms of current asthma. Only seven children managed to perform the spirometry satisfactorily. One child had low forced vital capacity and one had hyperresponsive airway. The only risk factor found to be associated with current asthma was the birth month, with those children born early in the year at higher risk of developing current asthma. Seventeen of 48 children (35%) had a bodyweight below the third percentile at the corrected age of 1 year. Eleven of these seventeen children (65%) demonstrated catch-up growth at assessment. Abnormal CXR was found in 25 of 40 children (63%). All had normal pulse oximetry and ECG.
CONCLUSIONS: Bronchopulmonary dysplasia children had a significantly higher risk than the general population of developing current asthma (odds ratio 4.7; 95% confidence interval 3.4-6.5; P<0.0001). The importance of birth month suggests that early life experience is important in the pathogenesis of asthma, even in BPD children. The long-term growth of BPD children was much better than previously reported.