Abstract
Few studies exist investigating lung function trajectories of those born preterm, however growing evidence suggests some individuals experience increasing airway obstruction throughout life. Here we use the studies identified in a recent systematic review to provide the first meta-analysis investigating the impact of preterm birth on airway obstruction measured by the FEV1/FVC ratio.
Cohorts were included for analysis if they reported FEV1/FVC in survivors of preterm birth (<37 weeks’ gestation) and control populations born at term. Meta-analysis was performed using a random effect model, expressed as standardised mean difference (SMD). Meta-regression was conducted using age and birth year as moderators.
55 cohorts were eligible, 35 of which defined groups with bronchopulmonary dysplasia (BPD). Compared to control populations born at term, lower values of FEV1/FVC were seen in all individuals born preterm (SMD −0.56), with greater differences seen in those with BPD (SMD −0.87) than those without BPD (SMD −0.45). Meta-regression identified age as a significant predictor of FEV1/FVC in those with BPD with the FEV1/FVC ratio moving −0.04 SDs away from the term control population for every year of increased age.
Survivors of preterm birth have significantly increased airway obstruction compared to those born at term with larger differences in those with BPD. Increased age is associated with a decline in FEV1/FVC values suggesting increased airway obstruction over the life course.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: No potential conflicts of interest were reported from Dr James Gibbons, Dr Christopher Course, Dr Emily Evans, Dr Sarah Kotecha, or Dr Shannon Simpson.
Conflict of interest: Dr Sailesh Kotecha reported grants from the Medical Research Council (MR/M022552/1) during the conduct of the study and grants from Health Technology Assessment program of the National Institute for Health and Care Research, Aspire Pharma, GSK, and the Moulten Foundation outside the submitted work.
Conflict of interest: No other disclosures were reported.
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- Received January 24, 2023.
- Accepted March 30, 2023.
- Copyright ©The authors 2023
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