{
  "abstract": "Introduction Lung-function outcomes among preterm-born children referred for pulmonology care are highly heterogeneous, and early determinants remain incompletely defined. We aimed to identify early-life factors associated with school-age lung function after preterm birth and to examine whether school-age spirometry patterns relate to subsequent lung-function trajectories.Methods Early-life analyses (n=511) examined predictors of forced expiratory volume in 1 s (FEV 1) and forced vital capacity (FVC) z-scores at ages 6–8 years using multivariable regression. Spirometry-based phenotypes included prematurity-associated preserved-ratio impaired spirometry (pPRISm), prematurity-associated obstructive lung disease (POLD) and prematurity-associated dysanapsis. Longitudinal mixed-effects models assessed lung-function trajectories from ages 8 to 21 years. Parallel analyses were conducted in the National Health and Nutrition Examination Survey (NHANES).Results Lower weight-for-height at 4 years was non-linearly associated with both FEV 1 and FVC at school age. Invasive ventilation in the first year of life was associated with lower FEV1 (β −0.62, 95% CI −0.96 to −0.28) and FVC (β −0.54, 95% CI −0.92 to −0.18). In exploratory analyses, pPRISm was inversely associated with neighbourhood income (risk ratio (RR) 0.63 per SD increase, 95% CI 0.46 to 0.88), and POLD was associated with invasive ventilation (RR 8.07, 95% CI 3.33 to 19.5). Similar subtypes and associations were observed in NHANES. School-age pPRISm was associated with progressive FEV1 z-score decline (age x pPRISm β −0.08 SD/year, 95% CI −0.15 to −0.02), while POLD was associated with improving FVC z-score (age x POLD β 0.13 SD/year, 95% CI 0.07 to 0.20).Discussion Early-childhood growth, neonatal respiratory exposures and school-age spirometry patterns help stratify long-term pulmonary risk among preterm-born children referred for pulmonary care.",
  "authors": [
    {
      "affiliations": [
        "University of Pennsylvania, Philadelphia, Pennsylvania, USA",
        "The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Jelte Kelchtermans"
    },
    {
      "affiliations": [
        "University of Pennsylvania, Philadelphia, Pennsylvania, USA",
        "The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Jessica L Rice"
    },
    {
      "affiliations": [
        "Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Brianna C Aoyama"
    },
    {
      "affiliations": [
        "Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Joseph M Collaco"
    },
    {
      "affiliations": [
        "University of Pennsylvania, Philadelphia, Pennsylvania, USA",
        "The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Sharon McGrath-Morrow"
    }
  ],
  "title": "School-age lung function after preterm birth: early-life determinants in a paediatric pulmonology cohort with comparison with NHANES",
  "uid": "b224d1db-821c-50d9-97f4-133cf5d756af"
}