Long-term pulmonary outcome in the preterm infant

Chronic respiratory morbidity is common following premature birth, particularly if complicated by the development of bronchopulmonary dysplasia (BPD). Affected infants can remain oxygen dependent for many months and frequently require hospital readmission in the first 2 years after birth. Troublesome, recurrent respiratory symptoms requiring treatment are common in prematurely born children, especially those who had BPD. The most severely affected may remain symptomatic and have evidence of airway obstruction even as adults. The studies examining adolescents and adults usually report patients who had 'classical' BPD, that is they often had had severe respiratory failure in the neonatal period with chronic pulmonary fibrosis and airway smooth muscle hypertrophy. Nowadays, infants are described as having 'new' BPD, developing chronic oxygen dependence despite initially minimal or even no respiratory distress. Affected patients, however, have reduced alveolarisation and experience deterioration in lung function over the 1st year after birth. It is essential to determine if they have 'catch up' and identify which strategies impair and most importantly promote lung growth in this very-high-risk population