Preemie lung problems may linger into adulthood

NEW YORK (Reuters Health) - Infants born prematurely are at increased risk for a chronic lung disease, called bronchopulmonary dysplasia, associated with prolonged use of oxygen therapy or a respirator.

A new study shows that bronchopulmonary dysplasia as a complication of extreme preterm birth is strongly associated with reduced lung function and structural abnormalities -- notably emphysema -- in adulthood.

Dr. Daniel C. Chambers from Brisbane's Prince Charles Hospital in Queensland, Australia and colleagues report their findings in the European Respiratory Journal for August.

Bronchopulmonary dysplasia, or BPD, affects up to one-third of infants born prematurely, with impaired lung function persisting into childhood. Until now, the effects on adult survivors were largely unknown.

Chambers and associates identified 21 people born in Western Australia between 1980 and 1987 prematurely weighing less than 1500 grams (3 pounds, 5 ounces) and who required a respirator.

Lung function tests performed when they were about 19 years old showed that 15, or 71 percent, had persistent respiratory symptoms, including wheeze, cough, and shortness of breath.

Only three subjects had normal lung function, the investigators note.

CT images of the lungs revealed structural abnormalities in all 19 subjects examined, with 84 percent having emphysema.

As technological advances increase survival of the most premature newborns, BPD -associated adult lung disease is likely to be seen more frequently, Chambers and his associates warn.

Physicians, they advise, "will need to become increasingly prepared" to ask about the birth history, recognize lung disease potentially associated with prematurity, and offer smoking cessation advice and long-term follow-up to young adults born preterm "as they move past maximum lung growth and into their late 20s and 30s."

SOURCE: European Respiratory Journal, August 2008.